Microsurgical treatment of large acoustic neuromas / 中华显微外科杂志

ABSTRACT

Objective To explore the skill of mien)surgical removal and preservation and functional recovery of facial nerve for large acoustic neuromas.Methods The clinical data of 82 consecutive patients with large acoustic neuromas operated upon through the suboccipital retrosigmoid approach were retrospectively reviewed.The cases with HB grade Ⅲ - Ⅵ of facial nerve were divided randomly into two groups,the one group was given conventional therapy and the other group was given Kabato rehabilitation training.Results In those cases,acoustic neuromas were totally removed in 77 (93.9%),subtotally removed in 5.Facial nerve was kept anatomically intact in 78 cases of the patients (95.1%).Recovery of facial nerve function was faster and more effective in the training group than that in the un-training group.During the follow-up ranging from 6 months to 3 years,among 5 cases of subtotally resection,2 cases relapsed.Three patients in our series complained of chronic headache postoperatively.No patient long time coma or died.Conclusion The goal of large acoustic neuromas treatment should be total removal in one stage and preservation of facial nerve function,as they determine a patient's quality of life.Kabat rehabilitation training is the effective method of functional recovery of facial nerve after operation.