Clinical experience of the microsurgery treatment of 53 patients with acoustic neuromas

Objective To investigate the preservation of facial nerves and management of IAC in operations of acoustic neuromas. Methods Fifty-three patients suffering from acoustic neuromas treated microsurgically with suboccipital retrosigmoid transmeatus approach in seat, and facial nerve function monitoring and brain stem evoked potential were also perfomed intraoperatively. The facial nerve function was evaluated and folloeed up after operation. Results Total resection of the tumor was achieved microsurgically in 46 cases(86.8%)and subtotal resection in 7 cases(13.2%). Anatomic preservation of facial nerve was achieved in 40 cases(75.5%) ,and functional preservation of facial nerve(H-B grading,above grade Ⅱ) was in 30 patients at discharge. A follow-up study from 3 months to 1 years was perfomed in 48 patients. Functional preservation of facial nerve(H-B grading,above grade Ⅱ)was in 36 patients. After operation completely paralysis of facial nerve was in 8 patients, and air skull was in 4 patients, and hydrocephalus was in 3 patients, and leakage of cerebrospinal fluid was in 2 patients. No patient infected and died. Conclusions It is very important of perfect microneurosurgical skills and the intraoperative monitoring to achieve the goal of total resection of acoustic neuromas and the anatomic reservation of facial nerve. Key words: Acoustic neuromas; Facial nerve; Iinternal auditory meatus; Microsurgical skills