Experimental Study Of The VEGF And IGF-I Expression Levels In Rabbit Anterior Segment Ischemia Induced Iris Neovascularization Mode

Objective: To investigate the surgery strategy and facial nerve preservationtechnology of Vestibular Schwannomas after microsurgical suboccipital retrosigmoidapproach. Analyse the reIevant factors that may affect the postoperative facial nervefunction preservation. In order to improve the therapeutic effect of acoustic neurinomasurgery and improve the quality of life of patients after operation.Material and Method: Collected the surgical treated97cases of auditory nervesheath tumor patients in Dalian medical university first affiliated hospital, in January2008-January2013, nearly five years. All of them have a head enhanced MRIexamination, and a microsurgical suboccipital retrosigmoid approach,and apostoperative pathological diagnosis of acoustic neurinoma.86cases were followed upfor3months to5years. Facial nerve function determined by the House-Brackmann (H-B grade) classification standard. The six levels: level I, the function is normal; level II,mild disorders; Level III, moderate disorders; Level IV, severe disorders; levelV,serious obstacle; level VI, facial completely paralyzed.Using SPSS19.0statisticalsoftware to analysis.Results: The86patients were all operated via suboccipital retrosigmoid approach.Including27males (31.4%),59females (68.6%), the male to female ratio is1:2.185.minimum age is21-year-old, maximum age of78years, with an average age of54.66years. The shortest duration is2months, the longest is20years, with an averageduration of42.3months. Tumor located on the left side in43cases, the right side in43cases. Tumor minimum diameter was0.6cm, maximum diameter was6.6cm.80caseswere total removal(92.9%),6cases of subtotal resection (7.1%). There were83caseshave an anatomy reservation of facial nerve (93.3%). And60cases have an anatomy reservation auditory nerve (69.8%).10patients have the Postoperative complications(11.6%), including intracranial infection in6cases (7.0%), gastrointestinal bleeding in1case (1.2%), the cerebellum, brainstem hemorrhage in1case (1.2%), death in3cases(3.5%). Postoperative facial nerve function assessment in accordance with theHouse-Brackman grading, grade I (normal)7cases (8.14%), grade II (mild impairment)in28cases (32.6%), grade III (moderate impairment)48cases (55.8%), grade IV(severe impairment),3cases (3.5%), grade V (a serious obstacle) cases, class VI(completely paralyzed)0case. SPSS19.0statistical software was used to analyze therelevant factors affecting the nerve function reserved. Age, tumor size, tumor cystic ornot indeed to the nerve function, and other factors such as gender, duration of diseasehave no correlation.60cases have an anatomy reservation auditory nerve (69.8%).49cases (57.0%) reserved the effective postoperative hearing,8patients improved hearingcompared with the preoperative accounted for16.3%(8/49), and17cases have nochanges accounted for34.7%(17/49),24cases were worse accounted for49.0%(24/49).Conclusion:1. The clinical manifestations of acoustic neuroma are complex and diverse,mainly by hearing loss, dizziness, headaches and facial sensory disorder primarily.2. The patient’s age, tumor size, sac variable or not are associated withpostoperative facial nerve function. The older Patient, larger tumor and sac variable is,the worse the postoperative facial nerve function.3. Micro-surgery treatment is still the first choice for the treatment of acousticneurinoma. Familiaring with the Microscopic anatomy of Cerebellum pons TriangleArea, adapting microsurgical techniques and a wealth of surgical experience are thekeys to tumor removal and improve the quality of life.