Analysis Of Factors Affecting The Accuracy Of Electrophysiological Monitoring Of Facial Nerve In Tumor Resection Of Cerebellopontine Angle

Objective:To explore the factors related to the interference of the facial nerve electrophysiological monitoring in the posterior cerebellopontine angle（CPA）tumor resection.And provide a reference for clinical application of neurophysiological monitoring in neurosurgery.Methods:Retrospective analysis of the First Hospital of Shanxi Medical University,Neurosurgery from June 2007 to December 2016 in line with the inclusion criteria of 108 cases of CPA tumor resection in the line of neurophysiological monitoring of complete data.Surgeons are the hospital or outside the hospital famous neurosurgery experts,professional electrophysiological monitoring staff monitoring.Comparison of intraoperative facial nerve electrophysiological monitoring results and postoperative facial nerve function recovery.Results consistent with the cases included in the same group,not the same points in the inconsistent group.To analyze the effect of various factors on the accuracy of facial nerve electrophysiological monitoring in patients undergoing CPA and the relationship between influencing factors and inconsistency by Statistical software.Results:（1）In this group of 108 cases of CPA tumor resection of facial nerve electrophysiological monitoring of postoperative facial nerve function recovery was 95cases（88.0%）,poor in 13 cases（12.0%）;87 cases of total resection of the tumor（80.6%）,partial resection in 21 cases（19.4%）;A total of 38 cases（35.0%）were false positive and false negative.（2）Univariate statistical analysis showed that gender,age,tumor size,tumor size and course of disease did not affect the accuracy of facial nerve electrophysiological monitoring（p> 0.05）.Whether the tumor is completely cut and Intraoperative PCO₂ affect the accuracy of tumor electrophysiological monitoring（p <0.05）,Multivariate logistic regression analysis also yielded similar results.According to the OR value can be obtained when the operation of PCO₂> 35 mmHg,the occurrence of intraoperative electrophysiological monitoring results and postoperative facial nerve function retention is not the same risk will increase 2.799 times（OR=3.799,OR95%CI:1.478⁹.762）;When the tumor is completely removed,the risk of inconsistency will increase by 4.142 times（OR=5.142,OR95%CI:1.105 23.920）.Both OR values 95% CI interval is too large,OR value is not high credibility.Conclusion:Intraoperative PCO₂ and tumor resection significantly affected the accuracy of facial nerve electrophysiological monitoring in the CPA tumor resection.n the course of tumor resection of cerebellopontine angle（CPA）.The application of neurophysiological monitoring can effectively improve the facial nerve retention rate.