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目的:探讨面神经(FN)与前庭神经鞘膜瘤(VS)空间位置对于术后FN功能恢复的影响。方法:101例单侧VS患者,采用扩大迷路径路显微全切除肿瘤,观察术中FN-VS空间位置,分为4型:第1位置为FN位于VS前方,第2位置为FN位于VS前上方,第3位置为FN位于VS上方,第4位置为FN位于VS后方。根据House-Brackmann面神经分级法评价患者术后7、30、90、180 d的FN功能。结果:术中FN解剖保留率达98%,术中发现FN-VS空间位置有43%为第1位置,33%为第2位置,24%为第3位置,未发现第4位置。术后180 d 73%FN功能良好,且随VS直径增大,术后FN功能良好率递减。FN-VS空间位置与术后FN功能呈显著相关,第1位置至第3位置术后FN功能良好率呈递减关系。结论:术中FN解剖保留率并不平行于术后FN功能良好率,VS直径与术后FN功能良好率相关,而FN-VS空间位置能够预测术后FN功能良好率。
Objective: To investigate the effect of facial nerve (FN) and vestibular schwannoma (VS) on the recovery of functional FN after operation. Methods: One hundred and one patients with unilateral VS were enrolled in this study. They were treated with microscopic resection of the enlarged obstruction pathways. The spatial location of FN-VS during operation was observed and classified into 4 types: FN in front of the first position, FN in front of the second position, Above, the 3rd position is FN above VS and the 4th position is FN behind VS. According to House-Brackmann facial nerve grading, the FN function was evaluated at 7, 30, 90 and 180 days after operation. Results: The FN-anatomic retention rate was 98%. FN-VS space position was found in 43% of the first position, 33% of the second position, 24% of the third position, and the fourth position was not found. After 180 days, 73% FN functioned well, and with the increase of VS diameter, the rate of good FN function decreased after operation. FN-VS spatial location and postoperative FN function was significantly related to the first position to the third position of FN function was a good decrease. CONCLUSION: The FN anatomic retention rate is not parallel to the postoperative FN function good rate. The VS diameter is related to the postoperative FN function good rate, while the FN-VS spatial position can predict the postoperative FN function good rate.