天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (6): 625-628.doi: 10.11958/20202517

• 临床研究 • 上一篇    下一篇

听神经瘤术后并发耳鸣及脑脊液漏的影响因素分析

贺鹏，李冉，罗文凯，尚伟，刘安龙
  

  1. 1安阳市人民医院（安阳市中心医院）东院区神经外科（邮编455000），2影像科
  • 收稿日期:2020-09-11 修回日期:2021-02-21 出版日期:2021-06-15 发布日期:2021-06-15
  • 通讯作者: 贺鹏 E-mail:ddti500@163.com

Analysis of related factors of tinnitus and cerebrospinal fluid leakage after acoustic neuroma #br#

HE Peng, LI Ran, LUO Wen-kai, SHANG Wei, LIU An-long #br#   

  1. 1 Department of Neurosurgery, 2 Department of Radiology, East Hospital of Anyang People's Hospital (Central Hospital of
    Anyang City), Anyang 455000, China
  • Received:2020-09-11 Revised:2021-02-21 Published:2021-06-15 Online:2021-06-15

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摘要： 目的 探讨听神经瘤患者显微切除术后耳鸣及脑脊液漏发生的影响因素。方法 选取经手术治疗的127 例听神经瘤患者，根据肿瘤最大径将其分为大型肿瘤组43例，中型肿瘤组46例，小型肿瘤组38例，比较3组听神经 瘤显微切除术后耳鸣及脑脊液漏的发生率差异。分析听神经瘤显微切除术后耳鸣及脑脊液漏发生的影响因素。结果 127例患者中术后发生耳鸣54例（42.52%）、脑脊液漏49例（38.58%）。大型肿瘤组耳鸣的发生率高于小型肿瘤 组（P＜0.017），大型肿瘤组脑脊液漏的发生率高于中、小型肿瘤组（P＜0.017）。与无耳鸣组比较，耳鸣组病程长，术 前内听道扩大比例、内听道后壁部分磨除比例高，手术时间长（P＜0.05）；与无脑脊液漏组比较，脑脊液漏组年龄大， 病程长，术前内听道扩大比例、内听道后壁部分磨除比例高，手术时间长（P＜0.05）。肿瘤较大是影响听神经瘤术后 发生耳鸣的独立危险因素；肿瘤较大、手术时间较长是影响听神经瘤术后发生脑脊液漏的独立危险因素（P＜0.05）。 结论 尽早发现听神经瘤，避免肿瘤体积增大和缩短手术时间可降低术后耳鸣及脑脊液漏的发生风险。

关键词: 神经瘤, 听, 显微外科手术, 耳鸣, 脑脊液漏, Logistic模型, 肿瘤长径

Abstract: Objective To explore the influencing factors of tinnitus and cerebrospinal fluid leakage in patients with
acoustic neuroma after microsurgery. MethodsA total of 127 patients with acoustic neuroma treated in the department of
neurosurgery of our hospital from October 2017 to January 2020 were selected as the study objects. Patients were divided
into large tumor group (43 cases), medium tumor group (46 cases) and small tumor group (38 cases) according to the long
diameter of tumor. The incidence of tinnitus and cerebrospinal fluid leakage was compared between the three groups. The
influencing factors of tinnitus and cerebrospinal fluid leakage after acoustic neuroma microsurgery were analyzed. Results
Among the 127 patients, 54 (42.52%) cases of tinnitus occurred and 49 (38.58%) cases of cerebrospinal fluid leakage
occurred after operation. The incidence of tinnitus was higher in the large tumor group than that in the small tumor group
(P＜0.017). The incidence of cerebrospinal fluid leakage was higher in the large tumor group than that in the small and
medium tumor group (P＜0.017). Compared with the non tinnitus group, the tinnitus group had a longer course of disease, a higher proportion of preoperative internal auditory canal enlargement, a higher proportion of internal auditory canal posterior wall abrasion, and a longer operation time (P＜0.05). Compared with the group without cerebrospinal fluid leakage, the group with cerebrospinal fluid leakage had older age, longer course of disease, higher proportion of preoperative expansion of internal auditory canal, higher proportion of partial abrasion of posterior wall of internal auditory canal and longer operation time (P＜0.05). Larger tumor size was an independent risk factor for tinnitus after acoustic neuroma operation (P＜0.05), and larger tumor size and longer operation time were independent risk factors for the cerebrospinal fluid leakage after acoustic neuroma operation (P＜0.05). Conclusion The early detection of acoustic neuroma can reduce the risk of tinnitus and cerebrospinal fluid leakage after acoustic neuroma microsurgery.

Key words: neuroma, acoustic, microsurgery, tinnitus, cerebrospinal fluid leakage, Logistic models, tumor length