Exploiting The Prognostic Factors And Prediction Model Of Postoperative Cochlear Nerve Function For Acoustic Neuroma

Objective:With the rapid development of the medical equipment and technology,the goal of acoustic neuroma microsurgery has gradually developed from saving life,reducing mortality,and complete tumor resection in the early stage to cranial nerve function protection and postoperative nerve function recovery.The retention rate of neural anatomy and function of the facial nerve after acoustic neuroma microsurgery has generally improved,and at present,the research on hearing preservation and the recovery of the cochlear nerve function after microsurgery has gradually become a research hotspot.Methods:In this study,the case series of 79 acoustic neuroma patients who underwent microsurgery by the same surgeon were collected in the Department of Neurosurgery,Xiangya Hospital,Central South University from February 1,2018 to August 31,2020.The preoperative and postoperative hearing classification was graded according to The American Academy of Otolaryngology-Head and Neck Surgery(AAO-HNS)hearing classification.Based on Pearson correlation coefficient,Logistic Regression model,and model accuracy-precision test,the important factors for postoperative cochlear nerve function were derived,and establish a mathematical model that predicts postoperative hearing classification.Results:We analyzed a relatively homogeneous cohort of 79 acoustic cochlear patients who underwent microsurgery by the same surgeon,ranging from 13 to 73 years old,with an average age of 47±13 years old,including 31 males(39.24%)and 48 females(60.76%).AAO-HNS hearing classification was improved or unchanged in 68 cases(86.08%)and decreased in 11 cases(13.92%).The Pearson Correlation Coefficient,Logistic Regression model,and model Accuracy-Precision test identified that age,the preoperative AAO-HNS hearing classification,and the cystic and/or solid tumor were the important factors affecting postoperative cochlear nerve function.The Area Under Curve(AUC),which is the area under the Receiver Operating Characteristic(ROC)curve and is an evaluation index of the merits of the model,was found close to 0.83 for predicting the preoperative AAO-HNS hearing classification(Forecast Accuracy:83%)in the validation set.Conclusion:The anatomical integrity preservation of the cochlear nerve is an important basis for postoperative hearing protection.Microsurgery is still the preferred treatment option;postoperative cochlear nerve function is related to surgical approach selection.In our study,age,preoperative AAOHNS hearing classification,and tumor cystic/solid were considered as important factors influencing postoperative AAO-HNS hearing classification,and the mathematical prediction model can accurately predict the prognosis of postoperative cochlear nerve function.For different patients,to preserve cochlear nerve function,an individualized treatment plan should be formulated based on the comprehensively considering its clinical characteristics.