A Meta-analysis Of Electrophysiological Monitoring For Preservation Of Facial Nerve Function In Acoustic Neuroma Resection

Objective:To assess the clinical value of neurophysiological monitoring to preservation of facial nerve in microsurgery of acoustic neuromas.Methods:Following the principle of evidence-based medicine and the strategy of Cochrane system evaluation, taking the computer retrieval method and manual retrieval method to search Pubmed, OVID, The cochrane library, Annual reviews, Biomed central, Highwire press, CBMdisk, CNKI database et al. Collecting the related literatures about the neurophysiological monitoring in acoustic neuroma resection which were published in English and Chinese from1970to2013. And a meta-analysis was conducted on current literature concerning the outcome of facial nerve function between monitoring and control groups.Results:The initial search yielded3,023papers, Further screening by two authors narrowed the results to34articles. Finally eight papers met our inclusion criteria for analysis. Meta-analysis was conducted by different follow-up time on current literature the outcome of facial nerve function between monitoring and control groups. The OR (odds ratio) of the facial nerve function protection(H-B scale:â…  and â…¡) rates that the monitoring group compared to the control as follows:(1) The OR merged of facial nerve preservation rates after operation at3months was2.21,95%CI (confidence interval)(1.12,4.37), the difference was statistically significant (P<0.05);(2)The OR merged of facial nerve preservation rates after operation at1year was3.79,95%CI (2.16,6.67), the difference was statistically significant (P<0.05); The RR (risk ratio) of the facial nerve function was impaired (H-B scale:â…¤ and â…¥) that the monitoring group compared to the control as follows:(1) The RR merged of the facial nerve function was impaired after operation at3months was0.79,95%CI (0.48,1.31), the difference was not statistically significant (P<0.05);(2)The RR merged of the facial nerve function was impaired after operation at1year was0.12, 95%CI (0.03,0.44), the difference was statistically significant (P<0.05).Conclusion:Neurophysiological monitoring may effectively preserve the facial nerve function in acoustic neuroma resection. The functional preservation rates of facial nerve could be increased and the risk of the facial nerve function was impaired would be reduced by using the technique of Neurophysiological monitoring in the long term.