| Objective:To study the differences in clinical characteristics and postoperative facial nerve dysfunction between sporadic young patients with acoustic neuroma and middle-aged and elderly patients undergoing surgical treatment,in order to improve the understanding of this disease and provide a reference for the formulation of corresponding clinical treatment strateg y.Materials and methods:A retrospective analysis was conducted on the clinical data of 22 sporadic young patients with acoustic neuroma admitted to the Department of Neurosurgery in the First Affiliated Hospital of Fujian Medical University from January 2015 to October 2020,and accepted the surgical treatment of 205 middle-aged and elderly patients with acoustic neuroma as control group in the same period.The research object was defined as group A,and the control group was defined as group B.All patients were performed with plain and enhanced MRI,CTA or MRA before operation.All operations were performed by suboccipital-retrosigmoid approach,and the acoustic neuroma was confirmed by postoperative pathology.Postoperative follow-up was conducted through outpatient follow-up visits supplemented by telephone follow-up,and the House-Brackmann(H-B)facial nerve function classification was used as the grading standard,and the patient’s facial nerve dysfunction was assessed at three months after the operation.The evaluation criteria was defined H-B classificationⅠ-Ⅱas good,H-B classificationⅢ-Ⅳas acceptable,and H-B classificationⅤ-Ⅵas poor.To collect detailed cases of eligible patients with acoustic neuroma information(gender,first symptom,duration of disease,tumor side,tumor size,presence of cystic change,the changes of hemoglobin before and after surgery,postoperative facial nerve function hierarchical),and analyze the differences between the case data of young patients with acoustic neuroma and middle-aged and elderly patients,in order to summarize the clinical characteristics of the sporadic young patients with acoustic neuroma.Results:In this study,there were 11 males and 11 females in group A,with a male to female ratio of 1:1;group B with 81 males and 124 females,with a male to female ratio of 1:1.53(P=0.341).There were 9 patients with tumors on the left in group A,13 patients with tumors on the right,107 patients with tumors on the left in group B,and 98 patients with tumors on the right(P=0.314).In group A,there were 14 patients with tumor cystic transformation,8 patients without cystic transformation,138 patients with tumor cystic transformation in group B,and 67 patients without cystic transformation(P=0.727).The average course time of patients in group A was25.63±27.17 months,and it was 38.96±60.01 months in group B(P=0.077).In terms of the first symptoms before surgery,hearing loss,tinnitus and headache were the most common symptoms between the two groups.In group A,18 cases were followed up,4cases were lost to follow-up,10 cases were good,8 cases were acceptable,and 0 case was poor.In group B,163 cases were followed up,42 cases were lost to follow-up,98 cases were good,61 cases were acceptable,and 4 cases were poor.The two groups of patients have no significant differences in gender,tumor side,cystic change,duration of disease,first symptoms before surgery,and facial nerve function assessment after surgery.The average tumor volume in group A was 34.16±33.19 cm~3,it was 17.85±16.07 cm~3 in group B(P=0.033).The hemoglobin in group A was 21.27±18.94 g/L,and in group B was11.25±13.41 g/L(P=0.024).The two groups of patients have significant differences in tumor size and hemoglobin changes before and after surgery.According to the preoperative CTA or MRA examination,the intraoperative observations of the surgeon,and the postoperative pathological slice blood vessel distribution,the results showed that the patients in group A had abundant blood supply.Conclusions:1.The clinical characteristics of sporadic young acoustic neuroma patients are similar to those of middle-aged and elderly patients with acoustic neuroma,but the sporadic young acoustic neuroma patients have the characteristics of large tumor volume and abundant tumor blood supply.2.Young patients should see a doctor in time and undergo related examinations to confirm the diagnosis when they have symptoms such as hearing loss or tinnitus.3.In the process of clinical treatment,the corresponding treatment plan should be formulated according to the clinical characteristics of sporadic young acoustic neuroma patients to ensure the quality of life of the patients after surgery. |
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