| Objective To summarize the protection of cranial nerve in acoustic neuroma microsurgery and main complications under neurophysiological monitoring, explore the value of neurophysiological monitoring in microsurgery of acoustic neuroma.Methods From January2013to January2014, the clinical data of42patients with acoustic neuroma were retrospectively analyzed in the first affiliated hospital of Xinxiang Medical University and Beijing Sanbo Brain Hospital. All patients did not undertake previous surgery or radiotherapy. The Cranial nerve protection for acoustic neuroma under neurophysiological monitoring, facial nerve function of1day or2weeks after operation and main postoperative complications were analyzed.Results In this group of42cases, the tumors were totally removed in37(88.1%) cases, and subtotally removed in5(11.9%) cases, facial nerves were anatomically preserved in39(92.9%) cases. Facial nerves were broken in3cases, in which2cases were determined intraoperatively. Main postoperative complications:facial paralysis in3cases, cerebrospinal fluid leakage in2case, the wound subcutaneous effusion in1case, exposure conjunctivitis in4cases, transient hoarseness and drink cough in4cases, no intracranial hematoma or death. According to the facial nerve function House-Brackmann grade, one day after surgery, facial nerve function was grade I in7(16.7%)cases, grade II in15(35.7%)cases, grade III in13(31.1%), grade IV in6(14.3%) cases and grade V in1(2.4%)case. None is grade VI. Two weeks after surgery, facial nerve function was grade I in10(23.8%) cases, grade II in13(31.1%) cases, grade III in12(28.6%) cases and grade IV in4(9.5%) cases, grade V in1(2.4%) case and grade VI in2(4.8%) cases. Conclusion Application neurophysiological monitoring technology in acoustic neuroma microsurgery can improve total removal of acoustic neuroma and preservation of facial nerve function and reduce the postoperative complications. |
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