| Objective:Acoustic neurilemmoma is a common tumor with the highest incidence in schwannoma.At present,surgical microsurgery is still the main treatment for acoustic neurilemmoma.Facial nerve dysfunction is one of the complications that seriously affect the quality of life of patients after operation.Therefore,how to protect facial nerve function has become the focus of attention of neurosurgeons.By comparing the facial nerve function after operation between the two groups of patients who underwent neuroelectrophysiological monitoring during the operation of acoustic schwannoma and those who did not,the significance of neuroelectrophysiological monitoring in protecting facial nerve function was illustrated.Methods:Use the computer to search The Cochrane library,PubMed,China Biomedical Literature Database,Wanfang Full-text Database,China Knowledge Network,VIP Chinese Science and Technology Journal Database,and manual search,Google search.Search Chinese and English literature from 2000 to 2018.Collect relevant literature on the use of neuroelectrophysiological monitoring in the operation of sphincter sphincter tumors,screen the literature according to the inclusion and exclusion criteria,extract the relevant data in the literature,and evaluate the quality of the included literature,using the Review Manager 5.3 software Meta package.Meta-combination analysis,by comparing the monitoring group and the control group,after comprehensive analysis,the recovery and difference of postoperative facial nerve function in each subgroup were obtained.Results:After the initial search and the relevant results are recorded,the statistics show that 1,384 documents are finally obtained,and then the literature is screened,48 documents that meet the requirements are selected,and the full text is obtained by using various retrieval methods and methods.After the analysis,17 articles were included for research.According to the postoperative follow-up time group,the relevant data were sub-combined and analyzed,and the short-term and long-term facial nerve functions were compared.In the monitoring group,the facial nerve function was good(HB°Ⅰ and °Ⅱ)compared with the control group.The odds ratio(OR)was:(1)2 weeks postoperative OR combined=3.10,95%CI[2.17,4.43],Z=6.19(P<0.05),the difference was statistically significant(P<0.05),the incidence of the monitoring group was higher than the control group;(2)6 months after surgery and above OR=3.81,95%CI[2.51,5.79],Z=6.27(P<0.05),the difference was statistically significant(P<0.05),the incidence of the monitoring group was higher than the control group.The odds ratio(OR)of the moderate to severe facial dysfunction(HB°Ⅲ and °Ⅳ)in the monitoring group compared with the control group(1)OR=0.50,95%CI[0.35,0.70],Z=3.95(P<0.05),the difference was statistically significant(P<0.05),the incidence of the monitoring group was lower than the control group;(2)the postoperative 6 months and above OR combined=0.41,95%CI[0.26,0.66],Z=3.67(P<0.05),the difference was statistically significant(P<0.05),the incidence of the monitoring group was lower than the control group.The risk ratio of the monitoring group to severe facial nerve function disorder(HB°Ⅴand °Ⅵ)compared with the control group was RR(risk ratio):(1)2 weeks postoperative RR combined=0.29,95%CI[0.15,0.55],Z=3.79(P<0.05),the difference was statistically significant(P<0.05),the incidence of the monitoring group was lower than that of the control group;(2)the postoperative 6 months and above RR combined=0.28,95%CI[0.16,0.50],Z=4.33(P<0.05),the difference was statistically significant(P<0.05),the incidence of the monitoring group was lower than the control group.Conclusion:The application of neuroelectrophysiological monitoring in the operation of auditory schwannomas significantly improves the incidence of facial nerve function(HB°ⅠI and °Ⅱ)and effectively reduces the risk of facial nerve function at HB°Ⅲ and below. |
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