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摘要: 侧颅底区域上承颅脑, 下接颈部, 其间穿行重要的血管、神经、位听器官, 解剖结构复杂。切除病变同时保留重要组织器官功能是侧颅底外科的基本原则, 在神经医学、介入医学、面神经外科发展的基础上, 颅底重要神经、血管的保护已经取得显著进步, 致命并发症及其他神经功能缺失发生率已显著降低, 而听觉功能保护目前尚不理想, 如何进一步保护听觉功能逐渐成为研究热点。选择正确治疗方式、恰当的手术入路、内镜技术的应用、术中听觉电生理监测以及术中听觉功能重建等对于听觉功能保护非常重要。Abstract: The anatomy of the lateral skull base is very complicated, which supports the brain upwards and connects the neck downwards with a large number of crucial structures passing through, including important blood vessels, nerves, and vestibular and auditory apparatuses. The basic principle of lateral skull base surgery is resecting the lesion and meanwhile preserving the function of important tissue and organs. With the development of interventional medicine, neuromedicine and facial nerve surgery, protection of important nerves and blood vessels of the skull base has made significant progress, and fatal complications and neurological defects have been greatly reduced. However, the protection of auditory function is not ideal, which has gradually become a research hotspot. The selection of appropriate treatment and surgical approach, the usage of endoscopic techniques, intra-operative auditory electrophysiology monitoring, and intraoperative reconstruction of the auditory function are all very critical for hearing protection.
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Key words:
- lateral skull base /
- surgery /
- hearing protection
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[1] Manolidis S, Jackson CG, Von Doersten PG. Lateral skull base surgery:the otology group experience[J]. Skull Base Surg, 1997, 7:129-137. doi: 10.1055/s-2008-1058604 [2] Wang AC, Chinn SB, Than KD, et al. Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach[J].J Neurosurg, 2013, 119:131-138. doi: 10.3171/2013.1.JNS1297 [3] Rampp S, Rensch L, Simmermacher S, et al. Intraoperative auditory steady-state monitoring during surgery in the cerebellopontine angle for estimation of postoperative hearing classes[J].J Neurosurg, 2016, 14:1-10. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=d246332d3c406603c57b192a2059e0c3 [4] Scheich M, Ginzkey C, Reuter E, et al. Quality of life after microsurgery for vestibular schwannoma via the middle cranial fossa approach[J]. Eur Arch Otorhinolaryngol, 2014, 271:1909-1916. doi: 10.1007/s00405-013-2671-1 [5] Rameh C, Magnan J. Quality of life of patients following stages Ⅲ-Ⅳ vestibular schwannoma surgery using the retrosigmoid and translabyrinthine approaches[J]. Auris Nasus Larynx, 2010, 37:546-552. doi: 10.1016/j.anl.2010.01.004 [6] Inoue Y, Ogawa K, Kanzaki J. Quality of life of vestibular schwannoma patients after surgery[J]. Acta Otolaryngol, 2001, 121:59-61. doi: 10.1080/000164801300006281 [7] Smouha EE, Yoo M, Mohr K, et al. Conservative management of acoustic neuroma:a meta-analysis and proposed treatment algorithm[J]. Laryngoscope, 2005, 115:450-454. doi: 10.1097/00005537-200503000-00011 [8] Whitmore RG, Urban C, Church E, et al. Decision analysis of treatment options for vestibular schwannoma[J]. J Neurosurg, 2011, 114:400-413. doi: 10.3171/2010.3.JNS091802 [9] Pollock BE, Driscoll CL, Foote RL, et al. Patient outcomes after vestibular schwannoma management:a prospective comparison of microsurgical resection and stereotactic radiosurgery[J]. Neurosurgery, 2006, 59:77-85. doi: 10.1227/01.NEU.0000219217.14930.14 [10] Elliott A, Hebb AL, Walling S, et al. Hearing preservation in vestibular schwannoma management[J]. Am J Otolaryngol, 2015, 36:526-534. doi: 10.1016/j.amjoto.2015.02.016 [11] Liu W, Ni M, Jia W, et al.How to address small and medium-sized acoustic neuromas with hearing:a systematic review and decision analysis[J].World Neurosurg, 2015, 84:283-291. doi: 10.1016/j.wneu.2015.03.013 [12] Husseini ST, Piccirillo E, Taibah A, et al. Salvage surgery of vestibular schwannoma after failed radiotherapy:the Gruppo Otologico experience and review of the literature[J]. Am J Otolaryngol, 2013, 34:107-114. doi: 10.1016/j.amjoto.2012.09.012 [13] Betchen SA, Walsh J, Post KD. Long-term hearing pre-servation after surgery for vestibular schwannoma[J]. J Neurosurg, 2005, 102:6-9. doi: 10.3171/jns.2005.102.1.0006 [14] Zhang Z, Nguyen Y, De Seta D, et al. Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients[J].Acta Otorhinolaryngol Ital, 2016, 36:408-414. [15] Raut VV, Walsh RM, Bath AP, et al. Conservative management of vestibular schwannomas-second review of a prospective longitudinal study[J]. Clin Otolaryngol Allied Sci, 2004, 29:505-514. doi: 10.1111/j.1365-2273.2004.00852.x [16] Theodosopoulos PV, Pensak ML. Contemporary management of acoustic neuromas[J]. Laryngoscope, 2011, 121:1133-1137. doi: 10.1002/lary.21799 [17] Arthurs BJ, Fairbanks RK, Demakas JJ, et al. A review of treatment modalities for vestibular schwannoma[J].Neurosurg Rev, 2011, 34:265-277. doi: 10.1007/s10143-011-0307-8 [18] Omran A, De Denato G, Piccirillo E, et al. Petrous bone cholesteatoma:management and outcomes[J].Laryngoscope, 2006, 116:619-626. doi: 10.1097/01.mlg.0000208367.03963.ca [19] Moffat D, Jones S, Smith W. Petrous temporal bone cholesteatoma:a new classification and long-term surgical outcomes[J].Skull Base, 2008, 18:107-115. doi: 10.1055/s-2007-991112 [20] Tutar H, Goksu N, Aydil U, et al. An analysis of petrous bone cholesteatomas treated with translabyrinthine transoticpetrosectomy[J].Acta Otolaryngol, 2013, 133:1053-1057. doi: 10.3109/00016489.2013.811752 [21] Li Y, Liu H, Cheng Y. Subtotal resection of facial nerve schwannoma is not safe in the long run[J]. Acta Otolaryngol, 2014, 134:433-436. doi: 10.3109/00016489.2013.871746 [22] McRackan TR, Rivas AR, Wanna GB, et al. Facial nerve outcomes in facial nerve schwannomas[J]. Otol Neurotol, 2011, 33:78-82. http://cn.bing.com/academic/profile?id=54684c6eaea7f6c5d667eb355b34c1e3&encoded=0&v=paper_preview&mkt=zh-cn [23] Mowry S, Hansen M, Gantz B. Surgical management of internal auditory canal and cerebellopontine angle facial nerve schwannoma[J]. Otol Neurotol, 2012, 33:1071-1076. http://europepmc.org/articles/pmc3810424/ [24] Kida Y, Yoshimoto M, Hasegawa T. Radiosurgery for facial schwannoma[J].J Neurosurg, 2007, 106:24-29. doi: 10.3171/jns.2007.106.1.24 [25] Jacob JT, Driscoll CL, Link MJ. Facial nerve schwannomas of the cerebellopontine angle:the Mayo Clinic experience[J]. J Neurol Surg B Skull Base, 2012, 73:230-235. doi: 10.1055/s-0032-1312718 [26] Irving RM, Jackler RK, Pitts LH. Hearing preservation in patients undergoing vestibular schwannoma surgery:comparison of middle fossa and retrosigmoid approaches[J]. J Neurosurg, 1998, 88:840-845. doi: 10.3171/jns.1998.88.5.0840 [27] Staecker H, Nadol JB Jr, Ojeman R, et al. Hearing preservation in acoustic neuroma surgery:middle fossa versus retrosigmoid approach[J]. Am J Otol, 2000, 21:399-404. doi: 10.1016/S0196-0709(00)80051-4 [28] Wilkinson EP, Roberts DS, Cassis A, et al. Hearing Outcomes after Middle Fossa or Retrosigmoid Craniotomy for Vestibular SchwannomaTumors[J].J Neurol Surg B Skull Base, 2016, 77:333-340. doi: 10.1055/s-0035-1571166 [29] Hong SJ, Lee JH, Jung SH, et al. Can cochlear function be preserved after a modified translabyrinthine approach to eradicate a huge cholesteatoma extending to the petrous apex?[J]. Eur Arch Otorhinolaryngol, 2009, 266:1191-1197. doi: 10.1007/s00405-008-0874-7 [30] Song JJ, An YH, Ahn SH, et al. Surgical management options and postoperative functional outcomes of petrous apex cholesteatoma[J].Acta Otolaryngol, 2011, 131:1142-1149. doi: 10.3109/00016489.2011.593550 [31] Brackmann DE, Toh EH. Surgical management ofpetrous apex cholesterol granulomas[J]. Otol Neurotol, 2002, 23:529-533. doi: 10.1097/00129492-200207000-00023 [32] Rihani J, Kutz JW Jr, Isaacson B. Hearing Outcomes after Surgical Drainage of Petrous Apex Cholesterol Granuloma[J]. J Neurol Surg B Skull Base, 2015, 76:171-175. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=675a3b51724978ddebc7a46ece071901 [33] Rodgers SD, McMenomey SO, Sen C. Partial labyrinthectomy presigmoid transpetrosal resection of petroclival meningioma[J].Neurosurg Focus, 2014, 36:1. http://europepmc.org/abstract/med/24380530 [34] Kawase T, Toya S, Shiobara R, et al. Transpetrosal approach for aneurysms of the lower basilar artery[J]. J Neurosurg, 1985, 63:857-861. doi: 10.3171/jns.1985.63.6.0857 [35] Gross BA, Dunn IF, Du R, et al. Petrosal approaches to brainstem cavernous malformations[J]. Neurosurg Focus, 2012, 33:E10. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=2131af356a3091c445566b99e7fde9c3 [36] Kim SM, Lee HY, Kim HK, et al. Cochlear line:a novel landmark for hearing preservation using the anterior petrosal approach[J].J Neurosurg, 2015, 123:9-13. doi: 10.3171/2014.12.JNS132840 [37] Guo X, Tabani H, Griswold D, et al. Hearing Preservation During Anterior Petrosectomy:The "Cochlear Safety Line"[J].World Neurosurg, 2017, 99:618-622. doi: 10.1016/j.wneu.2016.11.019 [38] 杨仕明, 于丽玫, 于黎明, 等.听神经瘤手术的听力保存技术[J].中华耳鼻咽喉头颈外科杂志, 2008, 43:564-569. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhebyhk200808002 [39] Presutti L, Alicandri-Ciufelli M, Rubini A, et al. Combined lateral microscopic/endoscopic approaches to petrous apex lesions:pilot clinical experiences[J].Ann Otol Rhinol Laryngol, 2014, 123:550-559. doi: 10.1177/0003489414525342 [40] Shahinian HK, Ra Y. 527 fully endoscopic resections of vestibular schwannomas[J].Minim Invasive Neurosurg, 2011, 54:61-67. doi: 10.1055/s-0031-1275335 [41] Kempfle J, Kozin ED, Remenschneider AK, et al. Endos-copic Transcanal Retrocochlear Approach to the Internal Auditory Canal with Cochlear Preservation:Pilot Cadaveric Study[J].Otolaryngol Head Neck Surg, 2016, 154:920-923. doi: 10.1177/0194599816630979 [42] Battista RA, Wiet RJ, Paauwe L.Evaluation of three intraoperative auditory monitoring techniques in acoustic neuromas surgery[J]. Am J Otol, 2000, 21:244-248. http://www.ncbi.nlm.nih.gov/pubmed/10733192 [43] Piccirillo E, Hiraumi H, Hamada M, et al. Intraoperative cochlear nerve monitoring in vestibular schwannoma surgery-does it really affect hearing outcome?[J].Audiol Neurootol, 2008, 13:58-64. doi: 10.1159/000108623 [44] Lloyd SK, Glynn FJ, Rutherford SA, et al. Ipsilateral cochlear implantation after cochlear nerve preserving vestibular schwannoma surgery in patients with neurofibromatosis type 2[J].Otol Neurotol, 2014, 35:43-51. doi: 10.1097/MAO.0000000000000185 [45] North HJ, Mawman D, O'Driscoll M, et al. Outcomes of cochlear implantation in patients with neurofibromatosis type 2[J].Cochlear Implants Int, 2016, 17:172-177. doi: 10.1080/14670100.2016.1197587 [46] Matthies C, Brill S, Kaga K, et al. Auditory brainstem implantation improves speech recognition in Neurofibromatosis type 2 patients[J]. ORL, 2013, 75:282-295. doi: 10.1159/000350568 [47] Edgerton BJ, House WF, Hitselberger W. Hearing by cochlear nucleus stimulation in humans[J]. Ann Otol Rhinol Larvngol, 1982, 91:117-124. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=be3150578dfb53e2ab4a3a203cc8ffa3 [48] Laszig R, Kuzma J, Seifert V, et al. The Hannover auditory brainstem implant:a multiple-electrode prosthesis[J]. Eur Arch Otorhinolaryngol, 1991, 248:420-421. doi: 10.1007/BF01463568 [49] Laszig R, Sollmann WP, Marangos N. The restoration of hearing in neurofibrobromatosis type 2[J]. J Laryngol, 1995, 109:385-389. doi: 10.1017/S0022215100130257 [50] Sanna M, Di Lella F, Guida M, et al. Auditory brainstem implants in NF2 patients:results and review of the literature[J]. Otol Neurotol, 2012, 33:154-164. doi: 10.1097/MAO.0b013e318241bc71
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