Protection of intermediate nerve is as important a
Dr. Zhang Liwei, associate professor of neurosurgery, Beijing Tiantan Hospital, recently discovered in his research that the protection of intermediate nerve has the same importance as that of the facial nerve during a neurological operation. This project with the financial assistance from the Chinese Postdoctorate Science Fund provided much more scientific evidence for the prognostic functional classification of acoustic neuroma, and was of important significance for surgical planning to avoid intra-operative nerve injury.
, 百拇医药
During the surgery of schwannoma of acoustic nerve and partial carotid artery angiography (CPA), the protection of function of facial nerve is in itself an important parameter to check-out the medical quality. However, the intermediate nerve responsible for the supply of sensory fibers of the facial nerve and the parasympathetic fibers was rarely mentioned in medical literature and in clinical discussions. Consequently, many patients undergone successful operations of schwannoma of acoustic nerve suffered from complications of loss of taste, salivation, no excretion of lacrimal gland etc. Dr. Zhang carried out simulated surgery in 16 specimens of cadaver skull using three different surgical approaches to acoustic neuromas and observed the structural relationships of 32 intermediate nerves with the adjacent tissue at different locations.
, 百拇医药
The results showed that the intermediate nerve consisted of three portions, i.e. the segments of cerebellopontine angle, internal auditory canal and the facial nerve. Because of the thin size of the intermediate nerves and the absence of epineurium, 75 % of them manifest as single nerve roots and 20 % are devoid of myelin sheath and easily to be injured especially at the cerebellopontine angle. On the surface of vestibular region of the intermediate nerve there is a thin layer of fibrous membrane; the pars intermedia of this segment of the nerve and the facial nerve roots are the segments easily to be injured.
, 百拇医药
Among the three surgical approaches for acoustic neuroma, the sigmoid sinus translabyrinthine approach is able to expose the total course of intermediate nerve and its relationship with the adjacent structures. The infra-temporal transpetrous route is able to expose the pars intermedia of the cerebellopontine angle and the facial nerve, while the infra-occipital retro-sigmoid sinus approach generally will not be able to expose the pars intermedia of the cerebellopontine angle. Preferably, the first two approaches are selected for the protection of the intermediate nerve., 百拇医药
, 百拇医药
During the surgery of schwannoma of acoustic nerve and partial carotid artery angiography (CPA), the protection of function of facial nerve is in itself an important parameter to check-out the medical quality. However, the intermediate nerve responsible for the supply of sensory fibers of the facial nerve and the parasympathetic fibers was rarely mentioned in medical literature and in clinical discussions. Consequently, many patients undergone successful operations of schwannoma of acoustic nerve suffered from complications of loss of taste, salivation, no excretion of lacrimal gland etc. Dr. Zhang carried out simulated surgery in 16 specimens of cadaver skull using three different surgical approaches to acoustic neuromas and observed the structural relationships of 32 intermediate nerves with the adjacent tissue at different locations.
, 百拇医药
The results showed that the intermediate nerve consisted of three portions, i.e. the segments of cerebellopontine angle, internal auditory canal and the facial nerve. Because of the thin size of the intermediate nerves and the absence of epineurium, 75 % of them manifest as single nerve roots and 20 % are devoid of myelin sheath and easily to be injured especially at the cerebellopontine angle. On the surface of vestibular region of the intermediate nerve there is a thin layer of fibrous membrane; the pars intermedia of this segment of the nerve and the facial nerve roots are the segments easily to be injured.
, 百拇医药
Among the three surgical approaches for acoustic neuroma, the sigmoid sinus translabyrinthine approach is able to expose the total course of intermediate nerve and its relationship with the adjacent structures. The infra-temporal transpetrous route is able to expose the pars intermedia of the cerebellopontine angle and the facial nerve, while the infra-occipital retro-sigmoid sinus approach generally will not be able to expose the pars intermedia of the cerebellopontine angle. Preferably, the first two approaches are selected for the protection of the intermediate nerve., 百拇医药