Clinical Analysis Of Fluid-fluid Level In Cystic Vestibular Schwannoma

Objective:By collecting imaging data and related clinical data of patients with cystic vestibular schwannoma,the clinical and surgical effects of cystic vestibular schwannoma were evaluated,and the clinical significance of fluid-fluid level phenomenon in cystic vestibular schwannoma was analyzed.to provide theoretical support for individualized treatment of patients with cystic vestibular schwannoma.Methods:Fifty-four patients with cystic vestibular schwannoma treated in the first affiliated Hospital of Xinjiang Medical University from January 2017 to December 2021 were collected and divided into fluid-fluid level group and non-level group according to whether the MRI findings were fluid-fluid level or not.The clinical features,imaging features,intraoperative conditions,surgical results and prognosis of the two groups were retrospectively analyzed to explore the clinical significance of fluid-fluid level in cystic vestibular schwannoma.Results:According to the imaging findings,54 patients were divided into fluid-fluid level group(n = 21)and non-level group(n= 33).The average age of the fluid-fluid level group was 52.29 ±12.25 years old,and that of the non-level group was 51.76 ±13.47 and 0.885 years old.The average course of disease in the fluid-fluid level group was 34.29 ±36.79 months,while that in the non-level group was 41.61 ±39.26 months,P = 0.497.The average tumor size was 36.38 ±9.06 mm in the fluid-fluid level group,36.21±11.43 mm in the non-level group,and 0.955 in the non-leve group.Polycystic tumors accounted for 85.71% in the fluid-fluid level group and 75.76% in the non-level group.The percentage of peritumoral adhesion was 76.19% in the fluid-fluid level group and 48.48% in the non-level group(P < 0.05).The total tumor resection rate was 76.19% in the fluid-fluid level group and 90.91% in the non-level group.Complications occurred in 52.38% of the patients in the fluid-fluid level group and 21.71% in the non-level group.One week after operation,the proportion of good facial nerve function was 23.81% in the fluid-fluid level group and 39.39% in the non-level group(P > 0.05).One year after operation,good facial nerve function accounted for 33.33% in the fluid-fluid level group and 63.64% in the non-level group(P <0.05).Conclusion:Fluid-fluid level in cystic vestibular schwannomas often indicates a worse surgical prognosis.The formation of fluid-fluid level phenomenon may be related to repeated intratumoral bleeding.The cystic vestibular schwannoma with fluid-fluid level phenomenon is more closely related to the important nerves and blood vessels in the cerebellopontine angle region,more adherent to the surrounding normal tissue structure,more difficult to operate,and more likely to occur postoperative complications.postoperative neurological function is poor.These findings help to predict surgical outcomes and develop personalized treatment plans.