Abstract
Objective To investigate the method and clinical effect of microsurgical resection of small and medium-size acoustic neuromas via retrosigmoid approach. Methods The surgical effect, postoperative quality of life and postoperative nerve function preservation in patients with acoustic neuromas with the maximum diameter of <3 cm treated with microsurgery at the Department of Neurosurgery, Xiangya Hospital Central South University from October 2003 to November 2013 were analyzed retrospectively. The postoperative mean follow-up time was 36.7 months (range, 9-131 months). Results Seventy-six patients had total tumor removal, while one had subtotal removal. The intraoperative facial nerves, trigeminal nerves, petrosal veins were preserved anatomically, and anatomic preservation rate of the cochlear nerves was 68%. No patient died during the operation. Two patients had intracranial infection after procedure, 1 had cerebrospinal fluid leakage, and they were cured after symptomatic treatment. All patients returned to work within one year after procedure. The excellent rate of the long-term quality of life assessment (KPS score) was 100%. During the follow-up period, one patient had tumor recurrence, and his tumor was totally resected again. The postoperative facial nerve function was still House-Brackman grade 1. The excellent rate of facial nerve was 96% at the last follow-up. The effective hearing preservation rate was 29%. The symptoms were relieved or disappeared after procedure in 34 patients with preoperative facial numbness and pain. Conclusion For the maximum diameter <3 cm of acoustic neuroma, microsurgery can achieve higher total resection rate and neural function retention, and significantly relieve the clinical symptoms of trigeminal nerves. It can be used as a preferred treatment method. Key words: Neuroma, acoustic; Microsurgery; Facial nerve
Published Version
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