目的 探讨显微手术切除听神经瘤时岩静脉保护的方法和临床意义。方法 显微手术治疗听神经瘤147例，术中先行肿瘤内减压，再逐步分离肿瘤周边结构。岩静脉143例保护良好；4例术中被切断行电凝处理。结果 143例患者术后未发生小脑出血性梗塞。4例电凝处理岩静脉，其中1例发生一过性广泛性小脑水肿，随访18个月能生活自理，但仍有走路步态不稳，3例出现小脑出血性梗塞并水肿，其中1例死亡；2例经后颅窝减压后恢复良好，其中1例随访33个月无明显神经功能障碍，1例随访12个月尚有走一字路不稳。结论 在听神经瘤显微手术中应保护好岩静脉，一旦损伤需在手术后密切观察病情变化，做好再次后颅窝减压手术的准备。
Objective To discuss the preservation of petrosal vein and its clinical significance in the microsurgical operation of acoustic neuroma. Methods 147 patients with acoustic neuroma were operated, with internal decompression of the tumor firstly then dissected the tumor from surrounding structures. The petrosal vein was protected well in 143 cases and failed in 4 cases. Results No cerebellar hemorrhagic infarction was observed in 143 cases and the petrosal vein was preserved. One case occurred with extensive cerebellar edema, which had gait disturbance after 18 months followup. The other three cases occurred with vein infarction and hemorrhagic edema after petrosal vein damage. One was dead and the other two were recovered well after decompression of posterior cranial fossa. One had no significant neurological deficit after 33 months followup, while the other had difficulty in line walking after 12 months followup. Conclusion Petrosal vein should be well protected in the operation of acoustic neuroma; the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.