Clinical Features And Surgical Treatment Of Large Solid And Cystic Acoustic Neuroma

Objective:Comparative analysis of clinical characteristics between large cystic and solid acoustic neuroma, explore the differences of surgical treatment and postoperative complications between the two types of acoustic neuroma, and raise the awareness of the two types of acoustic neuroma.Methods:With retrospective analysis,we review the clinical data of74cases who suffered acoustic neuroma(diameter≥3cm) which treated by surgical operation in Neurosurgery department of Qilu hospital during January2012to December2013.According to the nature of the acoustic neuroma in surgery, the patients were divided into cystic groups (n=25) and solid groups (n=49). All patients were operated by retrosigmoid approach in the facial nerve monitoring. And compare clinical manifestations, the rate of tumor resection surgery, facial nerve retention rate, short-term postoperative facial nerve function, complication rates, average days of hospitalization between the two groups of patients.Results: Large cystic acoustic neuroma appear cerebellar dysfunction symptoms commomly, compared with large solid acoustic neuroma.25cases (33.8%) large cystic acoustic neuroma, with an average diameter of4.7±1.1cm, totally resected in17patients(68%), subtotally resected in8patients (32%),2deaths, facial nerve retained21cases (84%).49cases (66.2%) large solid acoustic neuroma, the average diameter of4.07±0.91cm, totally resected in43(87.8%), subtotally resected in5patients (10.2%), mostly resected1case (2%), facial nerve retained48cases (98%), no death. Follow-up postoperative assessment with face nerve function proceed by House-Brackmann (HB) grading standards after3days, grade I 8cases, grade Ⅱ5cases, grade Ⅲ5cases, grade IV4cases, grade V1case, grade VI2cases; large solid acoustic neuroma,16cases of grade Ⅰ,grade Ⅱ14cases, grade Ⅲ7cases, grade IV6cases, grade V5cases, grade Ⅵ1case. The occurrence of complications in5cases large cystic acoustic neuroma and12cases large solid acoustic. Large cystic acoustic neuroma hospitalize20.4±7.80days, a large solid acoustic neuromas hospitalize22.2±6.1days.Conclusion:l.The main clinical manifestations of large acoustic neuroma are facial and auditory nerve damage, and cerebellar dysfunctions.The Preoperative clinical manifestations of large cystic acoustic neuroma are atypical and mostly cerebellar dysfunction.2. Microsurgical operation is an effective treatment for large acoustic neuroma and facial nerve has a high retention rate.3. Short-term facial nerve function of large cystic acoustic neuroma is worse than that of solid acoustic neuroma.The totally resection rate is lower. Large cystic acoustic neuroma should be early diagnosed and early treated.4.There is no significant difference between two types of acoustic neuroma on hospital days and complication rate...