摘要
前庭神经鞘瘤是一种良性肿瘤,显微手术切除是重要治疗方式,目标是完全切除肿瘤的同时,保护面听等神经功能。随着影像学的发展,术前听力良好的患者数量增加,对术后听觉功能保留提出了更高的要求,术中听觉功能的监测、对蜗神经的识别和保护是神经电生理监测发展的重点。目前,主要的监测方法包括脑干听觉诱发电位、蜗神经复合动作电位、耳蜗电图、电诱发听觉脑干反应、耳后肌肉反应等,根据各监测技术特点、手术方式、病变位置及大小、术前听力水平等,在应用脑干听觉诱发电位监测的基础上,采用多模态监测是保护听觉功能的重要保障。
Vestibular schwannomas are benign tumors,and microscopic surgery is an important therapy aimed at completely removing the tumor while preserving the functions of nerves such as the facial and auditory nerves.With advancements in imaging technology,the number of patients with good preoperative hearing has increased,and higher requirements have been put forward for the preservation of postoperative auditory function.Intraoperative monitoring of auditory function,recognition and protection of the cochlear nerve are the focus of the development of neurophysiological monitoring.The main current monitoring methods include brainstem auditory evoked potentials,cochlear nerve compound action potentials,electrocochleography,electrically evoked auditory brainstem responses,and postauricular muscle reflexes.Based on the characteristics of various monitoring techniques,surgical approach,location and size of lesions,preoperative hearing level,etc.,it is crucial to adopt multimodal monitoring on the basis of brainstem auditory evoked potential monitoring for protecting auditory function during surgery.
作者
张剑宁
王秀英
ZHANG Jianning;WANG Xiuying(Department of Neurosurgery,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期1-5,共5页
Chinese Journal of Neurosurgical Disease Research
基金
国家自然科学基金(T2394483)。
关键词
前庭神经鞘瘤
监测
听觉
诱发电位
耳蜗神经
动作电位
手术中
Vestibular schwannomas
Monitoring
Auditory
Evoked potentials
Cochlear nerve
Action potentials
Intraoperative
