Effect Analysis Of Neurophysiological Monitoring In Acoustic Neuroma Surgery

Objectives:This study mainly discusses the significance of intraoperative neurophysiological monitoring and summarizes the usage and advantages of intraoperative neurophysiological monitoring in acoustic neuroma surgery.Methods:We have reviwed the demographic information and clinical data of acoustic neuroma patients who had received surgical treatment in department of neurosurgery from the Second Affiliated Hospital of Kunming Medical University between January 2017 and June 2020.Finally,according to the surgery whether assisted with the intraoperative neurophysiological monitoring,a total of 58 patients were divided into the group of intraoperative neurophysiological with monitoring(23 cases)and the group of simple microsurgery(35 cases).The age,gender,maximum diameter of tumor,left and right distribution of tumor,operation time,postoperative hospital stay,resection degree,postoperative function of facial nerve,unexpected secondary operation and other target data of all patients were collected.The statistical analysis of above data was achieved by SPSS 26.0 statistical analysis software.Resuits:Through comparative analysis of the data of the two groups,there were no significant differences in gender,age at operation,maximum diameter of tumor,left and right distribution of tumor between the two groups(P>0.05);②Operation time:the operation time of intraoperative neuroelectrophysiological monitoring assisted microsurgery group was significantly shorter than that of simple microsurgery group(355.22±115.15 vs 447.57±133.81 min),t=2.731,P=0.009<0.05,with a significant difference;③Postoperative hospital stay:the postoperative hospital stay of the intraoperative neuroelectrophysiological monitoring assisted microsurgery group was shorter than that of the simple microsurgery group(18.91±9.16 vs 22.94±14.43 days),t=1.181,P=0.243>0.05,the difference was not statistically significant;④Extent of tumor resection:the intraoperative neuroelectrophysiological monitoring assisted microsurgery group vs the simple microsurgery group,Z=-1.479,P=0.139>0.05,no statistically significant;⑤Rank sum test was used to analyze facial nerve function:3 days after operation,the facial nerve function of patients,Z=-1.997,P=0.046<0.05,with a significant difference.Two weeks after operation,the facial nerve function,Z=-1.854,P=0.064>0.05,no statistically significant.Follow up period(6 months to 3 years)facial nerve function,Z=-1.924,P=0.054>0.05,no statistically significant;⑥Chi square test was used to analyze the facial nerve function:3 days after operation,the facial nerve function of patients,x 2=1.464,P=0.226>0.05,no statistically significant.Two weeks after operation,the facial nerve function,x2=4.038,P=0.044<0.05,with a significant difference.Follow up period(6 months to 3 years)facial nerve function,χ2=4.938,P=0.026<0.05,with a significant difference;⑦The rate of unexpected reoperation:the intraoperative neuroelectrophysiological monitoring assisted microsurgery group vs the simple microsurgery group(4.35%VS 8.57%),χ~2=0.008,P=0.927>0.05,no statistically significant.Conclusions:For acoustic neuroma surgery,compared with the simple microsurgery group,the use of intraoperative neurophysiological monitoring assisted surgery can improve the operation efficiency and shorten the operation time;intraoperative neurophysiological monitoring assisted microsurgery can protect the anatomic integrity of facial nerve and improve the functional retention rate of facial nerve;Mastering the key points of neuroelectrophysiological monitoring and using it reasonably should be the necessary skill for the surgeon of auditory nerve surgery.