Analysis Of Clinical Effect Of Surgical Resection Of Acoustic Neuroma And Relevant Factors Of Hearing Preservation

Objective: To evaluate the effect of surgical treatment of acoustic neuroma through the posterior sigmoid sinus under neuroelectrophysiological monitoring and to explore related factors that affect postoperative hearing retention.Methods: A retrospective study was conducted on clinical data of 71 patients with acoustic neuroma admitted from January 2017 to December 2019 by Professor Wang Hong from the Nine Wards of Neurosurgery,Huanhu Hospital,Tianjin.Observe the patient’s age,gender,clinical symptoms,imaging performance,facial nerve function,hearing status,tumor size,cystic solidity,tumor invasion of the internal auditory canal before and after surgery,summarize the surgical effect and use statistical analysis to discuss Related factors affecting postoperative hearing retention.Results: Among the 71 patients with auditory nerve,37 were male and 34 were female.The minimum age is 23 years old,the maximum age is 72 years old,the average age is 51.8 ± 11.6 years old,25 patients with VS on the left,46 patients with VS on the right,the minimum tumor diameter is 15 mm,the maximum is 56 mm,and the average course is 30.6 ± 11.0mm,the shortest course is 3 days,the longest26 years,an average of 3.3 years.The follow-up time was 1-36 months,with an average of 7 months.Common clinical symptoms,50 cases of hearing loss,24 cases of tinnitus,11 cases of dizziness,22 cases of ataxia,15 cases of facial sensory abnormalities;2 cases of facial movement disorder(HB V-VI level),headache 5cases;1 case of intracranial abnormal noise,3 cases of unfavorable limb movement,1case of visual ghosting.Postoperative total tumor resection in 22 cases,accounting for 31%,near total resection in 22 cases,accounting for 31%,subtotal resection in 27 cases,accounting for 38%,facial nerve anatomical retention rate 100%,facial nerve function HBI-II 1 week after surgery Forty-nine patients,accounting for 71.0%,HBIII-IV,19 patients,accounting for 27.5%,HBV-VI,3 patients,accounting for1.5%,long-term(follow-up 1 month to 3 years)64 patients with facial nerve function HBI-II 92.8%,4 cases of HBIII-IV accounted for 5.8%,3 cases of HBV-VI accounted for 1.4%.There were 20 cases of useful hearing(PTA ≤ 50 d B)before surgery,including 6 cases of grade A hearing(PTA <30d B),14 cases of grade Bhearing(31d B≤PTA≤50d B),and 4 cases of useful hearing retention after surgery4 For example,accounting for 20%.Conclusion: 1.The postoperative facial nerve anatomical retention rate of 71 patients in this group of VS patients was 100%,the long-term excellent facial nerve function rate was 92.7%,and the effective hearing retention rate was 20%.Under the monitoring of neuroelectrophysiology,the important blood vessels and nerves are protected during the operation,the tumor can be removed to a greater extent,and good facial auditory nerve function is preserved;2.Postoperative hearing retention and tumor size,tumor invasion of the internal auditory canal The degree is related to the preoperative hearing level,and has nothing to do with the patient’s age,gender,and tumor solidity.