J Korean Neurosurg Soc.  2017 Feb;60(2):165-173. 10.3340/jkns.2013.0407.001.

Influencing Factors Analysis of Facial Nerve Function after the Microsurgical Resection of Acoustic Neuroma

Affiliations
  • 1Department of Neurosuregery, First Affliated Hospital, AnHui Medical Univesity, Hefei, China. 524594636@qq.com
  • 2Department of Pathology, First Affliated Hospital, AnHui Medical Univesity, Hefei, China.
  • 3Department of Neurosuregery, First Affliated Hospital, AnHui Medical Univesity, Hefei, China.

Abstract


OBJECTIVE
To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma.
METHODS
Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function.
RESULTS
Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann: excellent facial nerve function (House-Brackmann I-II level) cases accounted for 75.2% (79/105), facial nerve function III-IV level cases accounted for 22.9% (24/105), and V-VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I-II level) was 74.4% (58/78).
CONCLUSION
Acoustic neuroma patients after surgery, the long-term (≥1 year) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient's age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.

Keyword

Acoustic neuroma; Facial nerve function; Sigmoid sinus approach; Electrophysiological monitoring; Keyhole; Internal acoustic meatus

MeSH Terms

Acoustics*
Colon, Sigmoid
Facial Nerve*
Humans
Hydrocephalus
Microsurgery
Mortality
Neuroanatomy
Neuroma, Acoustic*
Outpatients
Recurrence
Retrospective Studies
Telephone

Reference

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