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Objective: To explore and understand the surface acoustic neuroma surgery neurophysiological monitoring methodology , accuracy , practicality, and tumor resection with facial nerve preservation relationships and achieve improved facial nerve function retention purposes. Methods: According to Gormley intracranial tumor typing method , 28 cases of acoustic neuroma patients with tumor diameter less than 2cm in 1 case , 2 ~ 4cm in 13 cases , 14 cases more than 4cm . Preoperative use Honse-Brackmann grading facial nerve function assessment , including 21 cases of grade Ⅰ , Ⅱ grade 4 cases , Ⅲ grade 3 cases . Adoption of the sigmoid sinus suboccipital approach micrographic surgery to remove the tumor . Intraoperative use of English玛格斯蒂姆development and production company Neurosign 100 monitors in 28 patients with unilateral acoustic neuroma intraoperative neurophysiological monitoring surface ; week after surgery according to House-Brackmann grading method to evaluate patients with facial nerve function . Results: 28 patients with tumor removal in 15 cases, subtotal resection in 11 cases, subtotal resection in 2 cases, no operative deaths . Resection cases, the small acoustic neuroma (≤ 2cm) 1 cases ( 100% ) , medium-sized acoustic neuromas (2-4cm) 9 cases ( 69.23% ) , large acoustic neuromas (≥ 4cm) 5 cases ( 35.71% ) , the larger the tumor , surgical resection more difficult . Facial nerve preservation 27 cases ( accounting for 96.43% ) . Week after facial nerve HB 10 cases of grade Ⅰ , Ⅱ grade 8 cases , Ⅲ grade 7 cases , Ⅳ grade 2 cases , Ⅴ grade 1 case . Facial nerve function well preserved (Ⅰ ~ Ⅱ grade ) of the cases, underwent tumor resection 9 patients , accounting for all full-cut cases, 60% underwent tumor subtotal resection in 7 patients , accounting for all the subtotal cases 63.64% , OK subtotal in 2 cases, accounting for 100% ; higher degree of tumor resection , the greater the possibility of facial nerve injury ; tumor diameter greater the higher the degree of difficulty of facial nerve preservation . Conclusion: acoustic neuroma surgery performed electrophysiological monitoring of the facial nerve facial nerve to improve retention rates provide effective technical assistance , the technology has high accuracy and practicality. Skilled microsurgical technique is still the key to preservation of facial nerve function .
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