The Significance Of Facial Nerve Electrophysiological Monitoring In Large Acoustic Neuroma Surgury

ObjectiveThe discussion of the meaning of facial nerve electrophysiological monitoringacross the nerve protection in the large acoustic neuroma surgeryMaterial and methodsStrict screening67patients with large acoustic neuroma, in the first affiliatedhospital of Zhengzhou university of surgical treatment in March2010～July2013.Screening criteria:①complete clinical data.②tumor are unilateral recurrent.③noknife or history of radiation therapy.④The operation were by the same operationneurosurgeons, in both before and after1week of operation facial nerve function ofpatients was evaluated by the same neurosurgeons according to standard House-Brackmann facial nerve function grading evaluation.⑤removal of the tumor arechoice under the pillow after sigmoid sinus approach.⑥Pathology was confirmed foracoustic neuroma.32cases of male,35cases of female, aged30～67(45.7±11.5).29cases on the right side,38cases of left were set to monitoring group, not applied tothe non-monitoring group. The monitoring group of31cases,13cases of male,female18patients, average age (44.9±11.2).The non-monitoring group of36cases, 14cases of male, female22cases, average age (45.8±11.7).To compare the rate oflarge acoustic neuroma resection and anatomy and retention function of the facialnerve of each group in before and after operation. Two groups of patients’ age, sex,tumor size and the nature of the tumor had no statistically significant difference (P>0.05).Results1, total removal rate of tumors: total resection proportion of tumor was82.3%inmonitoring group of cases; total resection rate of tumor in the non-monitoring groupwas79.4%, there was no difference between the two groups in statistical significance(P>0.05).2, Results of the facial anatomical retention: facial nerve anatomical retentionrate in cases of monitoring group is90.3%;The facial nerve anatomy retention rate ofnon-monitoring group cases was69.4%.The results of monitoring group wasobviously higher than that of the non-monitoring group, two groups was statisticallysignificant difference (P <0.05).3, Results of facial nerve function preservation1week after surgery: facial nervefunction retention rate in monitoring group is75.4%;The facial nerve functionretention rate in non-monitoring group cases was52.7%. Monitoring group issignificantly higher than the non-monitoring group, the differences between the twogroups have statistical significance (P <0.05).ConclusionFacial nerve electrophysiological monitoring in the large acoustic neuromasurgery can improve facial anatomical and functional retention rate, improve theeffect of surgical treatment.