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| Study on the Efficacy of Microdissection of 57 Cases of Auditory Neuroma and Analysis of Factors Influencing Postoperative Facial Nerve Function |
| WANG Yan, WANG Qiang, NIE Er, et al |
| The Affiliated Hospital of Xuzhou Medical University, Jiangsu Xuzhou 221002, China |
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Abstract Objective:To investigate the method and surgical effect of micro-resection of acoustic neuroma, and the influencing factors of facial nerve function after operation. Methods:The clinical data of 57 patients with acoustic neuroma admitted to the neurosurgery department of Affiliated Hospital of Xuzhou Medical University from August 2018 to October 2020 were retrospectively analyzed. The indexes that may be correlated with postoperative facial nerve dysfunction, such as operation time, postoperative infection, cerebrospinal fluid leakage and so on, were collected. Suboccipital retrosigmoid sinus approach was used for craniotomy, and neuroelectrophysiological monitoring was used during the operation to summarize the extent of tumor resection and the outcome of the disease. The above patients were followed up and evaluated at discharge and 3 months after operation, and the risk factors affecting facial nerve function were discussed according to House-Brackmann classification. Results:The total resection rate of acoustic neuroma was 91.22%, the postoperative infection rate was 7.02%, the hearing improvement rate was 87.72%, and the retention rate of acoustic nerve was 94.74%. 31 cases (54.39%) had normal facial nerve function at discharge, including 14 cases (24.56%) of House-Brackmann grade I and 17 cases (29.82%) of grade II; there were 26 cases of facial nerve function injury, including 11 cases of House-Brackmann grade III (19.30%) and 15 cases of grade IV~VI (26.32%). Three months after operation, 40 cases (70.18%) had normal facial nerve function, including 22 cases (38.60%) of House-Brackmann grade I and 18 cases (31.58%) of grade II; there were 17 cases of facial nerve function injury, including 10 cases of House-Brackmann grade III (17.54%) and 7 cases of grade IV-VI (12.28%). Conclusion:Tumor size, cystic change and peritumoral edema were independent risk factors for facial nerve dysfunction after operation (P=0.043,0.010,0.022). The larger the tumour, the presence of cystic degeneration and the more pronounced the peri-tumoural oedema, the greater the likelihood of post-operative facial nerve functional impairment.
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2022, Vol. 28 
