Minimally invasive surgical strategy for acoustic neuromas: an analysis of 415 cases
10.3760/cma.j.issn.1671-8925.2019.03.008
- VernacularTitle:听神经瘤的微创治疗策略(附415例分析)
- Author:
Lihua CHEN
1
;
Ruxiang XU
;
Wende LI
;
Bin YU
;
Kai SUN
;
Hao ZHAO
;
Hongtian ZHANG
;
Yi YANG
Author Information
1. 解放军总医院第七医学中心神经外科
- Keywords:
Acoustic neuroma;
Microsurgery;
Efficacy
- From:
Chinese Journal of Neuromedicine
2019;18(3):263-267
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the surgical strategy of minimally invasive treatment for acoustic neuroma and to improve the tumor removal rate and facial nerve function preservation rate. Methods Four hundred and fifteen patients suffering from acoustic neuromas, admitted to and treated by minimally invasive surgery via trans-suboccipital retrosigmoid transmeatus approach in our hospital from January 2008 to December 2016, were chosen in our study. Their clinical data were analyzed retrospectively. Postoperative Karnofsky behavioral status scale (KPS) was used to evaluate the prognoses of the patients. Postoperative routine enhanced MR imaging was performed to determine the degrees of tumor resection. Three months after surgery, House-Brackmann facial function grading (H-B) was used to evaluate the facial function of all patients. Results KPS indicated that excellent prognosis was noted in 399 patients (96.10％), good prognosis in 14 (3.37％), and poor prognosis in 2 (0.48％); the larger the tumor diameter, the smaller the proportion of patients with good prognosis. Total resection of the tumors was achieved in 387 patients (93.25％), sub-total resection in 24 (5.78％), and partial resection in 4 (0.96％); the larger the tumor diameter, the smaller the proportion of patients with total resection. There were 398 patients with facial nerve preservation in anatomy, and the anatomic preservation rate of facial nerve was 95.9％; there were 17 without anatomic preservation, and 12 received end to end anastomosis of facial nerve. Three months after operation, H-B grading I-II was noted in 334 patients (80.5％), grading III-IV in 76 patients (18.3％), grading V-VI in 5 patients (1.2％); the larger the tumor diameter, the smaller the proportion of patients with H-B grading I-II. No surgically related deaths occurred. Conclusion Early diagnosis and early microsurgical treatment of acoustic neuroma is helpful in improving the safety and efficacy of tumor resection.
