Brain Neoplasms
Application and efficacy analysis of the near-total resection strategy in acoustic neuroma surgery
Ke Pu, Hong Wang, Weiliang Ding, Huanyu Wang
Published 2016-01-28
Cite as Chin J Neurosurg, 2016, 32(1): 8-12. DOI: 10.3760/cma.j.issn.1001-2346.2016.01.003
Abstract
ObjectiveTo observe the relationship between the extent of tumor resection and postoperative tumor recurrence or facial nerve function.
MethodsA total of 154 patients with coustic neuroma operated by the same surgeon in Tianjin Huanhu Hospital from October 2004 to October 2014 were enrolled retrospectively. All patients were treated via suboccipital retrosigmoid transmeatal approach. The near-total resection strategy was used during operation. Part of the tumors closely adhered to the facial nerves were not removed forcibly. If there was part tumor residue, the internal auditory canal was not drilled open. The relationship between facial nerve function or tumor recurrence and tumor resection degree was analyzed. The patients with recurrent tumor were treated with Gamma knife.
ResultsIn 154 patients, 1 (0.6%) died during the operation, 124 were followed up, 30 were lost to follow up, and. the follow-up rate was 80.5%. The follow-up time ranged from 8 months to 10 years. In 124 patients, the total resection rate of acoustic neuroma was 19.3% (n=24), the near-total resection rate was 74.2% (n=92), and subtotal resection rate was 6.5% (n=8). The good rate of facial nerve function in 124 patents after procedure was 91.1% (n=113; House-Brackmann grade I to Ⅲ), the total resection group was 79.1% (19/24), the near-total resection group was 94.6% (87/92), the good proportion of the subtotal resection group was 7/8 (χ2=5.72, P=0.048). The recurrence rate was 16.1% (20/124), including 0 in the total resection group, 15.2% in the near-total resection group, the proportion of the subtotal resection was 6/8. There were significant differences (F=19.47, P=0.000). After Gamma knife treatment, the tumor volume increased again in 4 patients (3.2%) during the follow up period. They were reoperated.
ConclusionsAfter near-total resection of acoustic neuroma, the assisted gamma knife therapy may effectively control the growth of acoustic neuroma, and significantly improve the retention rate of facial nerve function. For the improvement of the quality of life after procedure is a feasible treatment scheme in the facial nerve and some closely tumor-adhered patients.
Key words:
Neuroma, acoustic; Facial nerve; Microsurgery; Recurrence; Radiosurgery
Contributor Information
Ke Pu
Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300060, China
Hong Wang
Weiliang Ding
Huanyu Wang
