Related Factors Analysis And Surgical Treatment Understand Of The Effect Of Facial Nerve Function On Post-operation Of Excision Of Acoustic Neuroma

Objective To analysis the related factors of the effect of facial nerve function onpost-operation of excision of acoustic neuroma and discuss the Surgical techniques andsurgical therapeutic strategies of acoustic neuroma.Method30patients which diagnosed acoustic neuroma and undergo the excisionof acoustic neuroma from Jan2007to Dec2012in our hospital were chosen toperformance a retrospective analysis. All operations were conducted in microsurgicalmethod and all patients had the pathological diagnosis. The followed time were from3month to5years. House-Brackmann(H-B) grade of facial nerve function was used foranalysing the all patients facial nerve function after operation.To analysis the relatedfactors of the effect of facial nerve function on post-operation of excision of acousticneuroma and discuss the Surgical techniques and surgical therapeutic strategies ofacoustic neuroma.Result All30patients were operated the excision of acoustic neuroma insuboccipital retrosigmoid approach(SO). There are16male(53.3%) and14(46.7%)female in the study. The proportion of male/female is1:0.875. The average of age is51.1years. The maximum age is67years old and the minimum age is25years old. Theaverage course of disease are34.8month. The maximum course of disease is11yearsand2month as the minimum. There are14tumor in left side and16in right and nopatient on both side. The average diameter of tumor is3.7cm. The maximum diameterof tumor is1.4cm and6.3cm as the minimum. The Matthies and Sammi grade ofacoustic neuroma was used for all patient. There is no patient in T1grade. There are2patients in T2grade,2patients in T3a,3patients in T3b,8patients in T4a and15patients in T4b.28tumor of patients were resected completely and2patients partially.Facial nerve of25patients(83.3%) are anatomical retention. There are normal audition retention in13patients(43.3%). The post-operation complication occurred in3patients(10%). Hemorrhage occurred in one patient, cerebrospinal fluid fistula occurredin one patient and intracranial infection occurred in one patient. The followed time werefrom3month to5years. According to the H-B grade of facial nerve function, there are3patients(10%) in level I,4patients(13.3%) in level II,11patients(36.7%) in level III,11patients(36.7%) in level IV and1patients(3.3%) in level V. There was no patientsuffered from facial nerve paralysis completely(level VI). According to the statisticalanalysis, the size of tumor is the independence related factor of the effect of facial nervefunction. Sex, age, course of disease, cystic change and surgical approach can not affectfacial nerve function independently. In13patients of audition retention,2patientsimproved,3patients no change and3patients worsen by comparison of preoperative.Conclusion1.According to the statistical analysis, the size of tumor is theindependence related factor of the effect of facial nerve function.Sex, age, course ofdisease, cystic change and surgical approach can not affect facial nerve functionindependently.2.The major therapeutic strategy of acoustic neuroma is surgical treatment. Thekey to the successful operation are to be familiar with the anatomy of the cerebellumangle area, microsurgical technique and lots of experience of excision of acousticneuroma.3.The effective methods to prevent cerebrospinal fluid fistula are stuffing theinternal auditory canal by the fat or muscle and daubing the bone wax.4.The individual therapy must used in people of acoustic neuroma according tocareer, age, physical condition, audition and the expect of operation.