Facial Nerve Reservation in Large Acoustic Neuroma Surgery

Objective:To summarize and analysis the skills of facial nerve reservation in large acoustic neuroma surgery.Methods:Fifyty-seven patients with large acoustic neuroma were operated via suboccipital retrosigmoid transmeatal approach for reserving facial nerve.The pathological-anatomic relationships of tumor and facial nerve were studied,accompanied with nerve monitoring.Postoperative following up had continued from 6 months to 5 years.Results:Total tumors resection was achieved in 54 patients(94.7%),subtotal in 3 patients(5.3%).Facial nerves was kept anatomic intact completely in 52(91%)of the patients and anatomic intacat partially in 5 patients(9%).Conclusions:With effective nerve monitoring,the excellent microneurosurgical technique and the familiarity to facial nerve anatomy are essential.It is key skill for keeping facial nerves anatomic intact to identify brainstem segment and intrameatus segment of facial nerves,which is usually not stick on tumor,then separate the tumor along the nerve.