Intraoperative facial nerve reservation in patients with acoustic neuromas

Objective To summarize the experience in intraoperatively reservating facial nerves in patients with acoustic neuromas. Methods The clinical data of 142 patients with acoustic neuromas, who were treated in our hospital from September, 2007 to September, 2011, were analyzed retrospectively. All the patients were treated by microsurgery through suboccipital retrosigmoid approach under neurophysiological monitoring of the facial nerves. Results The total resection of the tumors was achieved in 136 (95.7%) patients and subtotal in 6 (4.3%). The facial nerves were anatomically reservated in 132 (93.0%). All the patients were followed up from 3 months to 2 years and the outcomes showed that the facial nerves function of 78 (54.9%), 53 (37.3%) and 11 (7.8%) patients belonged in House-Brackmann grades Ⅰ～Ⅱ , Ⅲ～Ⅳ and Ⅴ Ⅵ respectively. Conclusions Fully understood the anatomy of cerebellopontin angle, especially the positional relationship between the acoustic neuroma and facial nerve, and skilled microsurgical techniques are helpful to the increase in the rate of total resection of the acoustic neuromas and the reservation rate of facial nerve. The intraoperative neurophysiological monitoring is a good method to increase the reservation rate of facial nerve in the patients with aconstic neuromas.