Risk Factors Analysis Of Facial Nerve Function After Excision Of Acoustic Neuromas

Objective:This essay aims to analyze risk factors that relavent to facial nerve founctions after excision of acoustic neuromas by retrosigmoid approach in the intraoperative neurophysiological monitoring,thus pridicting the outcomes of the facial nerve founctions after surgery;meanwhile,we disscuss the surgical strategies and facial nerve preservation techniques in order to improve living standards of patients.Methods:With retrospective analysis,we reviewed the previous clinical data of 42 cases who were diagnosed acoustic neuroma and received surgical operation treatment in Neurosurgery department of Qilu hospital during January 2014 to March 2016.All operations were performed by the same person in retrosigmoid approach under the facial nerve monitoring.The following factors,such as gender,age,course of disease,tumor site,tumor size,whether tumor cystic degeneration exist,were analysed and compared with the 1 year post-opration facial nerve founction based on the House-Brackmann grade.Also surgical thchniques and strategies were discussed below.Results:All 42 patients were received the operation and facial nerve were all anatomical retention.In the study,there were 17 male and 25 famale.The maximum age was 74 years;the minimum age was 23 years and the average age was 49.2±12.3 years.The maximum course was 20 years;the minimum course was 1 month and the average couse was 50.9±50.4 months.14 tumors were on the left side and 26 were on the right and 2 cases had tumors on both sides.The maximum diameter of tumor was 5.3cm;the minimum diameter was 1.5cm and the average was 3.4±1.1cm.There were 26 cases of tumor that exist tumor cystic degeneration while 16 cases were not.One year later,all patients were followed up about the facial nerve founction according to House-Brackmann facial nerve grading system.And there were 5 patients in H-B ?,17 in H-B ?,12 in H-B ?,8 in H-B?.According to statistical analysis,age of patients,course of disease and tumor sizes were the related risk factors of facial nerve founction.While other factors such as gender,tumor site and whether tumor cystic degeneration exist can not influence the facial nerve founction.Conclusion:1.The tumor sizes had a negative correlation with facial nerve founction one year after surgery according to the statistical analysis.While other factors such as gender,age of patients,course of disease,tumor site and whether tumor cystic degeneration exist can not influence the facial nerve founction.2.Microsurgical removal was the major effective therapeutic strategy of acoustic neuroma and facial nerve had a high retention rate.3.According to different tumor sizes,individual theapy should be performed to improve the outcomes.