[超微创手术理念在听神经瘤切除术中的应用与发展]。

Q J Zhang, G J Wang, D Y Han
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引用次数: 0

摘要

随着医学的发展,外科手术也经历了从传统手术到微创手术,再到超微创手术(SMIS)的发展和演变。同时,减少手术创伤、保留和重建神经功能逐渐成为现代前庭裂隙瘤(VS)切除手术的新目标。根据患者术前是否具有实际听力,前庭裂神经瘤手术可分为保留听力手术(后蚓部入路和中窝入路)和非保留听力手术(传统的迷宫外入路)。提高保留听力手术的听力保留率和重建非保留听力手术患者的听力是一大挑战和热点。在耳鼻咽喉头颈外科中,传统的迷路入路比例最高,具有面神经保留率高、颅内并发症少等优点。然而,由于切除了耳蜗神经和迷宫,耳蜗出现纤维化,患者失去了通过人工耳蜗植入重建听力的机会。新的改良迷宫途径可以保留耳蜗神经,有效减少耳蜗纤维化,为人工耳蜗植入重建听力提供了机会。这是前庭裂隙瘤手术的又一重要突破。
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[Application and development of super minimally invasive surgery concept in acoustic neuroma resection].

With the development of medicine, surgery has also experienced the development and evolution from traditional surgery to minimally invasive surgery, and then to super minimally invasive surgery (SMIS). Meanwhile, reducing surgical trauma and preserving and reconstructing nerve function have gradually become new goals of modern vestibular schwannoma (VS) resection surgery. The surgery of VS can be divided into hearing-preserving surgery (retrosigmoid approach and middle fossa approach) and non-hearing-preserving surgery (traditional translabyrinthine approach), according to whether the patient has practical hearing before operation. Improving the hearing preservation rate of hearing-preserving surgery and reconstructing the hearing of patients with non-hearing-preserving surgery are major challenges and hotspots. The traditional translabyrinthine approach has the highest proportion in the Department of Otolaryngology-Head and Neck Surgery, with the advantages of high facial nerve preservation rate and few intracranial complications. However, due to the resection of the cochlear nerve and labyrinth, the cochlea develops fibrosis, and patients lose the opportunity to reconstruct hearing through cochlear implantation. The new modified translabyrinthine approach can preserve the cochlear nerve and effectively reduce cochlear fibrosis, providing an opportunity for cochlear implantation to reconstruct the hearing. This is another important breakthrough in vestibular schwannoma surgery.

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来源期刊
Zhonghua yi xue za zhi
Zhonghua yi xue za zhi Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
400
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