Thanh bên bài viết
Số lượt xem PDF: 71
EVALUATION OF THE MICROSURGERY RESULTS FOR ACOUSTIC NEUROMA USING AN INTRAOPERATIVE NERVE MONITORING SYSTEM
Nội dung chính của bài viết
Tóm tắt
Objectives: To evaluate the results of microsurgery for acoustic neuroma using an intraoperative nerve monitoring system. Subjects and methods: Cross-sectional, retrospective, and prospective description of 74 patients with acoustic neuroma who were microsurgically treated in Viet Duc University Hospital from October 2016 to March 2018. Results: Women (58.11%) were more predominant than men (41.89%). The age mean was 50.41% ± 9.43 years. There was no significant difference between the tumor location on the right and left side (54.41 compared to 45.59%). There were 40 patients with large tumors (54.05%), giant tumors in 20 patients (27.02%), and 14 patients (18.92%) with small tumors < 2.5cm. Postoperative magnetic resonance examinations were indicated for 100% of patients, in which 78.37% full of tumors were taken out and 21.63% were taken almost tumors. The rate of intact facial nerve was 93.3%. The damage rate of the facial nerve was about 20.28%. The most complications were cerebral edema, bleeding, hydrocephalus, death and meningitis (5.4%; 4.05%; 4.05%; 2.7%, and 1.35%, respectively). The recovery of the function of the VII nerve, grade I, II according to House-Brackmann was 79.72%. Conclusion: Neurosurgical intervention remains the main step in the effective management of vestibular schwannomas. Using a continuous monitoring system for the facial nerve in surgery for vestibular schwannoma has reduced the rate of post-operative facial nerve paralysis.
Chi tiết bài viết
Từ khóa
U dây thần kinh số VIII, Theo dõi thần kinh liên tục trong mổ
Tài liệu tham khảo
2. Myrseth E., Møller P., Pedersen P. H., et al. (2005) Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery; 56(5):927-35; discussion 927-935.
3. Jackler R. K., Whinney D. (2001) A century of eighth nerve surgery. Otol Neurotol; 22(3):401-416.
4. Arriaga Moisés A., Chen Douglas A. (2001) Facial Function in Hearing Preservation Acoustic Neuroma Surgery. Archives of Otolaryngology–Head & Neck Surgery; 127(5):543-546.
5. Berges C., Fraysse B., Yardeni E., et al. (1993) Intraoperative facial nerve monitoring in posterior fossa surgery: prognostic value. Skull Base Surg; 3(4):214-216.
6. Battista R. A., Wiet R. J., Paauwe L. (2000) Evaluation of three intraoperative auditory monitoring techniques in acoustic neuroma surgery. Am J Otol; 21(2):244-248.
7. Colletti V., Fiorino F. G., Carner M., et al. (2000) Intraoperative monitoring for hearing preservation and restoration in acoustic neuroma surgery. Skull Base Surg; 10(4):187-195.
8. De Seta E., Bertoli G., De Seta D., et al. (2010) New development in intraoperative video monitoring of facial nerve: A pilot study. Otol Neurotol; 31(9): 1498-1502.
9. Minahan R. E., Mandir A. S. (2011) Neurophysiologic intraoperative monitoring of trigeminal and facial nerves. J Clin Neurophysiol; 28(6):551-565.
10. Brackmann D. E., Owens R. M., Friedman R. A., et al. (2000) Prognostic factors for hearing preservation in vestibular schwannoma surgery. Am J Otol, 21(3): 417-24.
11. Cerullo L. J., Grutsch J. F., Heiferman K., et al. (1993) The preservation of hearing and facial nerve function in a consecutive series of unilateral vestibular nerve schwannoma surgical patients (acoustic neuroma). Surg Neurol, 39(6): 485-93.
12. Ciric I., Zhao J. C., Rosenblatt S., et al. (2005) Suboccipital retrosigmoid approach for removal of vestibular schwannomas: facial nerve function and hearing preservation. Neurosurgery, 56(3): 560-570; discussion 560-570.