Risk Factors for Postoperative Recurrence of Acoustic Neuroma

Background: Acoustic neuroma (AN), also known as vestibular schwannoma, is a benign, generally slow-growing tumor which might result in hearing loss, tinnitus, and disequilibrium. There are currently studies showing that the mean duration from the original operation and the diagnosis of recurrence was 4.2 years and the main recurrent symptoms were intracranial hypertension and walking disorder. Objectives: This study aimed to investigate the risk factors of postoperative recurrence of acoustic neuroma (AN) and provide a reference for its clinical prevention and treatment. Methods: This retrospective study included a total of 30 patients with recurrent AN and 23 patients with non-recurrent AN who were admitted to the Department of Neurosurgery of the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China from January 2013 to December 2018. The recurrence rate during the same periods was calculated and surgical treatment was decided according to the tumor size. The surgical effects of the recurrent patients further compared and investigated the way different treatments affected the preservation of the auditory nerve, facial nerve, and posterior group nerve and increased facial paralysis in AN patients. Results: Univariate analysis of 30 recurrent AN cases showed that tumor size, internal auditory canal invasion, and tumor blood supply are linked to the recurrence of AN (P<0.05). In addition, the multi-factor analysis demonstrated that rich blood supply, medium texture, intratumoral canal invasion, incomplete resection, and large-diameter tumor were independent risk factors for recurrent AN. We observed a significant difference in the preservation of the auditory nerve, but not in the preservation of the facial nerve and posterior nerve, and between the recurrent and non-recurrent AN patients. Conclusion: This study analyzed the risk factors of postoperative recurrence in patients with acoustic neuroma. The results showed that small size of tumor, tumor blood supply, tumor texture, tumor vascular invasion, and incomplete tumor resection were independent risk factors for recurrent AN patients. Therefore, these factors can be included in the reference indexes, and relevant prevention and treatment measures can also be taken during the operation to reduce the risk of postoperative recurrence.

Automated summary

This study analyzed the risk factors of postoperative recurrence in patients with acoustic neuroma and found that tumor size, blood supply, texture, vascular invasion, and incomplete resection were associated with recurrence. These findings can provide reference for clinical prevention and treatment.