The Role Of Intraoperative Facial Nerve Monitoring In Cerebellopontine Angle Microsurgery

Objective:To explore the significance of intraoperative facial nerve monitoring in cerebellopontine angle microsurgery.Method:A total of 40 unilateral cerebellopontine angle tumor patients were operated with intraoperative facial nerve monitoring(15 patients) or without intraoperative facial nerve monitoring(25 patients) and the rate of total resection and neurotomia were compared between the two groups.One week after the operation,the facial function of the two groups was evaluated and compared.Results:In the intraoperative facial nerve monitoring group(M group),the rate of total resection was 93.33%(14/15),and the rate of neurotomia was 86.6%(13/15). While,in the no monitoring group(N group),the rate of total resection was 72% (18/25),and the rate of neurotomia was 56%(14/25).The rate of total resection, especially,the rate of neurotomia in M group is higher than that in N group markedly (P＜0.05).One week after the operation,in M group,the rate of normal or near normal facial nerve function(House-Brackmann gradeⅠorⅡ) was 100%(1/1) in the small-size tumor subgroup,55.6%(5/9) in the moderate-size tumor group and 40% (2/5) in the large-size tumor subgroup;While,in N group,the rate of normal or near normal facial nerve function was 50%(1/2) in the small-size tumor subgroup,35.7% (5/14) in the moderate-size tumor group and 22.2%(2/9) in the large-size tumor subgroup.Whatever size of the tumor,the facial nerve function is better in M group one week after the operation,the rate of total facial nerve function reservation is significantly high in M group(P＜0.005).Conclusion:utilization intraoperative facial nerve monitoring can achieve significant improvement in the rate of total resection,especially the rate of neurotomia,and achieve better facial nerve function.