Objective: To explore the relationship between microsurgery and prognosis of acoustic neuroma. Methods: A total of 553 acoustic neuroma surgical cases admitted to the First Affiliated Hospital of Soochow University from January 1, 1986 to September 30, 2016, were collected retrospectively. They were divided into 1986-1995 group, 1996-2005 group, and 2006-2016 group. The general information, tumor size, preoperative hospital stay, total hospital stay, operation time, intraoperative blood transfusion, use of neuroelectrophysiological monitoring, internal auditory canal wall grinding, tumor resection degree, postoperative facial nerve function rating (House-Brackmann grading), discharge status, and quality of life assessment KPS of patients were statistically analyzed. Results: Compared with the 1986-1995 group and the 1996-2005 group, the average age of patients in the 2006-2016 group ((52.9±13.3) years) was larger but the overall tumor volume ((3.7±0.8) cm) was smaller, and preoperative hospital stay ((4.9±1.9) days), the total hospital stay ((19.4±6.4) days) was significantly reduced, the operation time ((4.6±1.0) hours) was shortened, the intraoperative blood transfusion rate (18.5%) was significantly reduced, the intraoperative neuroelectrophysiological monitoring utilization rate (8.9%), and the internal auditory canal rate (12.7%) was higher. While increasing the tumor total resection and near total resection rate (89.2%), it further improved the postoperative facial nerve function retention rate (71.5%), and significantly increased the discharge cure rate (88.5%) (P<0.05). At the same time, the postoperative quality of life assessment good rate (KPS≥60 points) and excellent rate (KPS≥80 points) of the patients in the 2006-2016 group increased significantly, reaching 94.2% and 45.8% (P<0.05). Conclusion: The maturity of microsurgery techniques and the use of intraoperative neuroelectrophysiological monitoring can shorten the treatment cycle of patients with acoustic neuroma, increase the tumor resection rate and postoperative facial nerve function retention rate, and effectively improve the quality of life of patients after surgery.
目的： 探究听神经瘤显微外科手术与患者预后关系。 方法： 回顾性收集苏州大学附属第一医院自1986年1月1日至2016年9月30日期间收治的共计553例听神经瘤手术病例，分1986—1995年组，1996—2005年组，2006—2016年组，分别对患者的一般资料、肿瘤大小、术前住院天数、总住院天数、手术时间、术中是否输血、是否使用神经电生理监测、是否磨内听道壁、肿瘤切除程度、术后面神经功能评级（House-Brackmann分级）及出院情况、生活质量评估（KPS）进行统计学分析。 结果： 与1986—1995年组及1996—2005年组相比，2006—2016年组患者年龄［（52.9±13.3）岁］更大，但整体肿瘤体积［（3.7±0.8） cm］更小，病例的术前住院天数［（4.9±1.9） d］、总住院天数［（19.4±6.4） d］显著减少，手术时间［（4.6±1.0） h］缩短，术中输血率（18.5%）显著降低，术中神经电生理监测使用率（8.9%）、磨内听道率（12.7%）较高，在提高肿瘤全切、近全切除率（89.2%）的同时，进一步提高了术后面神经功能保留率（71.5%），显著提高了出院治愈率（88.5%）（P<0.05）。同时 2006—2016年组患者的术后生活质量评估良好率（KPS≥60分）及优秀率（KPS≥80分）明显提高，分别高达94.2%和45.8%（P<0.05）。 结论： 显微外科手术技术的成熟和术中神经电生理监测的运用，能缩短听神经瘤患者的治疗周期，提高肿瘤切除率和术后面神经功能保留率，有效提高患者术后生活质量。.