Prevention of operative complications in acoustic neuroma opration

Objective To summarize our experience of prevention of operative complications in acoustic neuroma operation in order to improve the postoperative life quality of patients. Methods We retrospectively analyzed 119 patients harboring acoustic neuroma underwent microsurgical treatment through suboccipital retrosigmoid approach with or without intraoperative facial nerve monitoring (IFNM) at Tongji Hospital during 2000-2005 years. Results 71 tumors were total removed, 33 tumors were subtotal removed, the remaining 15 patients had their tumors partially removed. Operation complications included posterior group palsy in 18 cases, epidural hematoma in 2 cases, air accumulation in 2 cases, motor weakness in 2 cases and intracranial infection in 2 cases, wound healing problem in 3 cases and CSF leakage in 5 cases. There were 2 cases of death becaused of operation. The anatomic preservation of facial nerve was achieved in 95 cases (79. 8% ). The results of IFNM group was better then non-IFNM group. Conclusion The size of tumor and the extent of tumor removal are correlated to facial nerve preservation. Understanding the anatomy of CPA, the possible variation of the surroundings structures, using microsurgical technique and intraoperative neurophysiologic monitoring are key points for successful surgical results.