Case Report And Literature Review Of Hearing Protection After Acoustic Neuroma

Objective:In recent years,with the rapid development of medical examination technology and the continuous improvement of medical level,the clinical treatment of acoustic neuroma has entered a new era,The improvement of imaging technology and the advancement of intraoperative neurological monitoring technology have greatly reduced the mortality of acoustic neuroma.The treatment focus of acoustic neuroma has also developed from the direction of tumor omnidirectional neurological preservation,and the total tumor resection rate and facial nerve function retention rate have achieved satisfactory results.The preservation of hearing function has become a new research focus in the surgical treatment of modern acoustic neuroma.Method:Retrospective analysis of 4 patients with neurosurgery treated by surgical methods in the Second Hospital of Hebei Medical University(All cases were confirmed by postoperative pathological examination as acoustic neuroma).Analyze the hearing test data before and after surgery.The patient was analyzed for Speech Discramination Score(SDS)and Pure-tone Threshold Average(PTA),and further analysis and discussion of the precautions and operational points in the operation.Results: Among the patients who were admitted to the Department of Neurosurgery,Second Hospital of Hebei Medical University from December 2017 to March 2019,there were 4 patients with practical hearing before surgery,and they all had practical hearing after surgery.Conclusion:The integrity of nerve fibers and blood supply is the basic condition for postoperative hearing retention,and there is hope to preserve long-term hearing recovery.Therefore,hearing should be kept as much as possible in any case;The factors affecting hearing loss after acoustic neuroma are complex and diverse.The preoperative hearing status and the length of preoperative hearing loss have guiding significance for hearing retention;The origin and growth site of the tumor,especially the size of the tumor and the degree of expansion of the internal auditory canal are closely related to postoperative hearing retention;The surgeon's experience and choice of surgical approach are key factors for postoperative hearing retention;The use of intraoperative electrophysiological monitoring ensures operational accuracy,Endoscopic application can assist in surgery;In the microsurgery of acoustic neuroma,the neurosurgeon should select the most appropriate surgical approach based on the location of the tumor and its own surgical expertise,and minimize the traction,electrocoagulation,and hot and cold stimulation during the operation.Part of the vestibular nerve is preserved to avoid vasospasm and reduce hearing loss caused by edema and ischemia.