Prevention of facial nerve during operation for large acoustic neuroma

Objective To explore the prevention of facial nerve during operation for large acoustic neuroma.Methods Twenty-one patients with large acoustic neuroma were treated by resection of acoustic neurinoma via suboccipital-retrosigmoidal approach.Monitering was used to protect facial nerve during operation.Results Total removal was achieved in 19 cases(90%)and subtotal in 3 cases(10%).The facial nerve was preserved in anatomically in 17 cases(80%),H-B grade I-Ⅱ in 11 cases(52%),grade Ⅲ-Ⅳ 7 in cases(33%),and grade Ⅴ-Ⅵ in 3 cases(15%).No deaths,local or central infections or postoperative cerebrospinal fluid laks occurred.Conclusions The skilld microsurgical technique is crucial for increasing anatomical and functional preservation of facial nerve.Intraoperative monitoring might increase the preservation rate of facial nerve.