Prognostic Factors Analysis Of Facial Nerve Function In Patients With Acoustic Neuroma And Surgical Treatment Understand

Objective : The clinical features of 80 patients with acoustic neuroma were retrospectively analyzed to study the preservation of facial nerve function and the related factors that affect the long-term function of facial nerve after surgical excision of acoustic neuroma.In addition,through the clinical data of patients with acoustic neuroma surgery,summarize some of the surgical treatment experience and understand.Method: This study retrospectively analyzed the preoperative imaging data,intraoperative surgical data and postoperative follow-up data of 80 patients with acoustic neuroma diagnosed in the First Affiliated Hospital of China Medical University from July 2016 to September 2017.All patients were enrolled in this study to assess facial nerve function at 2 weeks and 6 months postoperatively using the House-Brackmann facial nerve function grading as a criterion.Record all the general information of patients,preoperative symptoms and postoperative complications.SPSS 21.0 software was used for statistical analysis of the study results,the results were calculated using P <0.05 to verify the statistical significance.Result: This study included 80 patients with acoustic neuroma resection,all patients underwent suboccipital-sigmoid sinus posterior approach to acoustic neuroma resection,the whole process of surgery are used electrophysiological monitoring,pathological reports were diagnosed as Acoustic neuroma.Sixty-five patients were completely dissected in 80 patients.There were 64 patients with good and moderate facial function at 6 months after operation,and 16 patients with facial nerve dysfunction.The different Koos grading,patient's age,sex,degree of resection,incision design and whether or not cystic degeneration were classified according to H-B classification of facial nerve function 6 months after surgery.The results obtained by Fisher exact probability and chi-square test for statistical analysis.The results showed that the Koos grading of tumors in patients with acoustic neuroma was significantly different from those in patients with facial nerve dysfunction after 6 months(P <0.05)(correlation coefficient of 0.3).Patient age,gender,incision design,cystic degeneration and degree of resection and postoperative 6 months patients with facial nerve dysfunction was no significant difference(P> 0.05).Conclusion: 1.There is a linear correlation between the Koos grading of acoustic neuroma and the preservation of facial nerve function in patients 6 months after surgery,that is,the higher the Koos grade of the tumor,the lower the postoperative preservation of the long-term neurological function,the facial nerve function HB classification will be higher;the other hand,the lower Koos tumor grade,postoperative long-term preservation of neurological function,the higher the level of facial nerve function in patients with HB will be lower.Age,gender,incision morphology,cystic degeneration and degree of tumor resection had no correlation with facial nerve function recovery after 6 months.2.Preoperative diffusion tensor imaging technique to reconstruct the facial nerve and tumor location and determine facial nerve walking situation,the use of electrophysiological monitoring techniques during surgery to help intraoperative anatomy and retention of the facial nerve.According to the patient's tumor size and location,from preoperative incision design to intraoperative attention to careful protection of the facial nerve and cochlear nerve and then to the surgery after the flap and other methods can improve the surgical results,and promote complete tumor resection and reduce the possible postoperative complication.