Facial Nerve Function Preservation And Hearing Preservation After Microsurgery In Vestibular Schwannoma

Objective:To investigate the surgery strategy and facial nerve preservation technology of arge acoustic neuroma after microsurgical reseetion via retrosigmoid approach. Analyse the possible relevant factors that may affect the postoperative facial nerve function and hearing preservation. in order to improve the Surgical treatment of tumor.Material and Method:Based on retrospective summary.A total of 35 cases acoustic neuromas were microsurgically removed via retrosigmoid suboccipital approach at the Neurosurgical Department of the First Teaching Hospital of Xinjiang Medical University from 2008.1-2011.4.16 patients were followed up for 3-14 months.The facial nerve function was assessed by using House-Brackmann facial nerve grading system.The hearing function was evaluated by Pure-Tone Threshold Average(PTA) of American Academy of Otolaryngology-Head and Neek Surgery(AAO-HNS) hearing grading classification.Analyze the factors of postoperative facial nerve function by statistical software SPSS 17.0.ResultsrTumor diameters were 20-60mm.,mean diameter was 38.4mm.Of 27 cases were total removal,6 cases of subtotal removal and 2 cases of nearly total removal. There were 33 cases have a clear anatomy reservation of facial nerve, anatomy reservation rate was 94.3%(33/35). Facial nerve function of 35 cases followed-up to 2 weeks were as follows:H-Bâ…¡in 7 cases, H-Bâ…¢grade in 26 cases, H-Bâ…£in 2 cases. There was no measurable hearing in all cases followed-up to 2 weeks.1 case whose preoperative PTA was 67dB had effective hearing (PTA was 46dB) 3 months after surgery. Conclusion:1, The clinical manifestations of acoustic neuroma are complex, taking headache and hearing loss as main.2, The postoperative(2 weeks after surgery) facial nerve function was correlated with patient age.3, The hearing function was poor 2 weeks after surgery,but there is possibility of hearing improvment long-term after surgery.4,Be skilled use of microsurgical techniques,supplemented by endoscope and intraoperative monitoring could help for total resection and for improving the quality of life of our patients.