Clinical features and surgical treatment of recurrent acoustic neuromas

Objective To investigate clinical features and surgical treatment of various types of recurrent acoustic neuromas. Methods The clinical data of 29 patients with recurrent acoustic neuromas were analyzed retrospectively who were admitted to Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2010 to October 2016. Those cases recurring following primary total removal were classified as total resection relapse group (11 cases) and those recurring after incomplete resection were classified as non-total resection relapse group (18 cases). Multiple parameters were compared including the mean age, the mean maximal diameter of primary and recurrent tumors, cystic/solid ratio, re-operation interval, postoperative complication, facial nerve function (House-Brackmann facial nerve function grading system) between the two groups. Results The mean age in the total resection relapse group was higher than that in non-total resection relapse group (52.2±10.8 years vs. 33.0±5.5 years, P 0.05). The follow-up time of 29 cases ranged from 3 to 37 months, and the mean follow-up time was 11.7±3.1 months. Among them, the tumors in 28 cases were totally removed and the remaining 1 case underwent near-total resection. The facial nerves were anatomically preserved in 27 cases (93%, 27/29), and the practical hearing was preserved in 2 cases (7%, 2/29). The good reservation rate of facial nerve function was 41% (12/29). Conclusions The mean re-operation interval after incomplete removal of acoustic neuroma is significantly shorter than that following total removal. In terms of preservation of neurological function, total resection of tumors in primary operation seems to be optimal for patients. Early surgery might be suggested for recurrent acoustic neuromas. Key words: Neuroma, acoustic; Recurrence; Disease attributes; Microsurgery