Cystic、Solid Acoustic Neuroma Microsurgery Operation Treatment Characteristics And Prognosis Analysis

Objective: To investigate the microsurgical treatment characteristics of solid acousticneuroma and cystic acoustic neuroma，and analysis clinically the ratio of tumor totalremoved，the retaining of intraoperative facial nerve and tumor recurrence.Methods: Retrospective analysis and summarize the clinical case data andpostoperative follow-up record of210cases of acoustic neuroma in our neurosurgeryfrom September2006to September2011, including82cases cystic acousticneuromas accounting for39%,and128cases solid tumors accounting for61%, bothgroups operated in facial nerve monitoring, postoperative nerve preservation、Postoperative tumor recurrence、postoperative quality of life of the two groups werecompared.Results:128solid tumors cases,totally removed in122cases (95.3%), subtotal in6cases (4.7%), facial nerve retained128cases (100%) and no deaths.In cystic group of82acoustic neuroma cases,72cases tumors totally resected(87.8%), subtotallyremoved10cases (12.2%), facial nerve retained72cases (87.8%), and no deaths.Follow-up postoperative assessment with face nerve function proceed by House-Brackmann (HB) pointslevel standards after two week, GradeΙand Ⅱaccount for105cases (84.4%) in solid group,18cases (13.9%)of Grade Ⅲ and Ⅳ,2cases (1.7%).Incystic group,GradeΙand Ⅱa ccount for58cases (70.7%), GradeⅢ and Ⅳ17cases(20.7%), Grade Ⅴ and Ⅵ7cases (8.6%). The total tumor removal ratio,facial nerveretention and function of retention (H-B GradeΙ,Ⅱ)in cystic group were significantlylower than the solid group, the two compared to be significant difference (P <0.05).cystic acoustic neuroma and solid acoustic neuroma have no difference in operationmortality and postoperative complications (such as intracranial infection,cerebrospinal fluid leakage).Conclusion:1.Cystic acoustic neuroma should be treated as a special type of acousticneuromas. and should be early detected and treated，2. Detailed understanding oftumor and surrounding tissues and structures through preoperative CT and MRIdetection，intraoperative facial nerve monitoring and skilled operation techniquescontribute to improve the total tumor resection rate and postoperative facial nerve function protected rate.