Influencing Factors Analysis Of Facial Nerve Function After Excision Of Acoustic Neuromas

Objective:Even though the facial nerve anatomy of the patients after acoustic neuroma surgery remains intact,some patients still have the symptoms of peripheral facial paralysis and other interview function injury.The purpose of this study was to explore the factors affecting the recovery of facial nerve function in patients with acoustic neuroma,and to provide a theoretical basis for the protection of facial nerve and the improvement of facial nerve function.Methods:A retrospective study was conducted on the clinical data of 43 eligible patients with acoustic neuroma admitted to the between January 2018 and August 2019.All the tumors were removed by the same surgeon and the same approach under the condition of electrophysiological monitoring.Six months after surgery,the facial nerve was graded using the house-brackmann facial nerve grading standard.Univariate analysis was conducted with the patient’s gender,age,tumor size,cystic and solid sex,and intraoperative facial nerve stimulation threshold,in order to explore possible influencing factors on postoperative facial nerve function recovery and improve postoperative quality of life.Results:Among the 43 patients with acoustic neuroma included in this study,17 were males and 26 were females.The age was 49±12.4 years old,the minimum age was 21 years old,the maximum age was 72 years old,the age ≤40 years old,41-60 years old and ≥61 years old,there were 10 patients,23 patients and 10 patients in each of the three groups.The minimum diameter of the tumor was 1.2cm,the maximum diameter was 6.2cm,and the average was 3.1±1.1cm.There were 28 cases and 15 cases in the two groups with diameters less than or equal to 3cm and greater than 3cm,respectively.Sixteen patients had tumors on the left and 27 on the right.There were 26 patients with cystic change and 17 patients without cystic change.There were 30 patients with intraoperative facial nerve stimulation threshold less than or equal to0.2m A and 13 patients with intraoperative facial nerve stimulation threshold greater than 0.2m A.Six months after surgery,facial nerve function was graded as follows: 4cases of grade I,19 cases of grade II,13 cases of grade III,7 cases of grade IV,and 0cases of grade V and VI.By statistical analysis of various factors,it was concluded that tumor diameter and intraoperative facial nerve stimulation threshold alone could affect the postoperative facial nerve function of patients.And other factors such as gender,age,tumor side,whether cystic change alone can not have an impact on facial nerve function after surgery.Conclusion:1.The larger the volume of the acoustic nerve tumor,the more likely it is to damage the facial nerve,and the worse the recovery of facial nerve function after surgery.Timely detection of the tumor and treatment can help the recovery of nerve function after surgery2.The greater the threshold value of facial nerve stimulation in the operation of acoustic neuroma,the worse the recovery of facial nerve function after surgery.IONM can not only effectively retain the facial nerve function and anatomical structure of patients,but also has a certain role in predicting the recovery of facial nerve function after surgery.3.Under intraoperative electrophysiological monitoring,the suboccipital retrosigmoid approach can effectively retain the anatomy and function of the facial nerve of the patient,and is an effective method for the treatment of acoustic neuroma.4.In the process of clinical treatment,different treatment plans should be formulated according to different patients,with the ultimate goal of improving patients’ quality of life.