神经内镜辅助下显微切除前庭神经鞘瘤 (附85例临床分析).

Objective To investigate the strategy of endoscopy-assisted microsurgery for treating vestibular schwannomas and evaluate its feasibility and significance in the surgical management. Methods The clinical data of 85 cases of surgically treated vestibular schwannoma admitted to Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2018 to June 2023 were analyzed retrospectively. Preoperative enhanced magnetic resonance imaging (MRI) scanning was performed, followed by tumor resection using a posterior keyhole approach via the suboccipital sigmoid sinus. According to the different surgical methods, 45 cases were divided into the group of internal auditory canal removal and resection of internal auditory canal tumors with the assistance of neuroendoscopy, and 40 cases in the group of simple microscopic resection. Tumor resection rate, facial nerve retention rate, facial paralysis, and complications were observed. Results There were no significant differences in baseline data between the two groups (P>0.05) except for age and tumor size (both P<0.01). The total resection rate of tumors in the internal auditory canal in the observation group (91.1%) was higher than that in the control group (60.0%) (P<0.05). The postoperative follow-up showed that the recurrence rate of tumor residual in the observation group (4.44%) was lower than that in the control group (15.0%) (P<0.05). There was no significant difference in facial nerve function and facial nerve preservation rate between the two groups (P>0.05). There was no significant difference in postoperative complications such as cerebrospinal fluid leakage and cerebellar contusion between the two groups. There was no death or disability in this group. Conclusions Neuroendoscopic assisted microsurgery for the treatment of acoustic neuroma has a definite therapeutic effect, high. safety, and is beneficial for the assessment and preservation of the facial nerve, especially in terms of the total resection rate of tumors in the internal auditory canal, when compared to full process microscopic resection. [ABSTRACT FROM AUTHOR]