[Analysis of the outcome of 12 cases of facial nerve tumors].

Objective:This study aims to provide a comprehensive summary of the pathogenesis, screening modalities, treatment strategies, repair modalities and preliminary results associated with facial nerve tumors. Methods:A retrospective analysis was conducted on the clinical data of 12 patients with facial nerve tumors who were admitted to our department between May 2018 and February 2023. The study population consisted of 5 males and 7 females, with ages ranging from 35 to 90 years. Clinical symptoms observed in these patients included facial nerve palsy, hearing loss, tinnitus, headache, and otalgia, etc. The severity of facial nerve dysfunction was assessed using the House-Brackmann（H-B） facial nerve function classification, with 3 cases classified as grade Ⅰ, 4 cases as grade Ⅲ, 2 cases as grade Ⅳ, and 3 cases as grade Ⅴ. There was a total of 11 patients who presented with hearing loss. Among these patients, 7 cases were diagnosed with conductive hearing loss, 2 cases with sensorineural hearing loss, and 2 cases with mixed hearing loss. The selection of the observation or surgical route for tumor localization was based on clinical symptoms, facial nerve function grading, and imaging examination results including temporal bone CT and enhanced MRI. Specifically, the location of the tumor was selected for observation or the best surgical route: 2 cases were followed up for observation, 1 case underwent biopsy, and 9 cases underwent tumor resection（7 cases of trans-mastoid approach, 2 cases of combined parotid-mastoidal approach）, concurrent repair of the facial nerve（4 cases of auricular nerve grafting, 3 cases of facial nerve diversion anastomosis, 2 cases of peroneal nerve grafting）. （4 cases of auricular nerve graft, 3 cases of facial nerve diversion anastomosis and 2 cases of peroneal nerve grafting）. Periodic postoperative evaluation of facial nerve function was conducted. Results:1-year follow-up was available. Intraoperatively, it was observed that 66.7%（6 out of 9） of the facial nerve tumors were present in multiple segments. Among these segments, the vertical segment had the highest proportion, accounting for 77.8%（7 out of 9）, followed by the labyrinthine segment/geniculate ganglion with 66.7%（6 out of 9） and the horizontal segment with 55.6%（5 out of 9）. Postoperative pathology confirmed 8 cases with nerve sheath meningioma, Ⅰ with seminal fibroma and 1 with hemangioma. Postoperative facial nerve function was graded as H-B grade I in one patient）, grade Ⅲ in three, grade Ⅳ in four, grade Ⅴ in 2, and grade Ⅵ in 2 patients. The auditory outcomes following surgery are as follows: 8 individuals experienced postoperative hearing loss, while 2 individuals demonstrated postoperative hearing preservation. Conclusion:In the case of patients presenting with facial nerve palsy as their initial symptom, it is imperative to consider the potential presence of a facial nerve tumor. To determine the appropriate course of action, it is necessary to ascertain the size and location of the tumors through imaging examinations. This information will aid in the decision making process regarding whether surgical intervention is warranted, and so, the most suitable approach. Additionally, the choice of repair method during the operation should be guided by the extent of facial nerve defect.

Pathogenesis and treatment progress in age-related hearing loss: a literature review.

Age-related hearing loss (ARHL) is a progressive sensorineural hearing loss caused by age. The pathogenesis of ARHL is not completely clear at present, but it is closely related to auditory nerve degeneration, metabolic disorders, vitamin deficiency, and genetics, especially mitochondrial DNA damage. With the acceleration of industrialization and urbanization in our country, the impact of environmental noise is increasing, and ARHL has become one of the most important factors affecting the quality of life of the elderly in our country. Therefore, hearing intervention for patients with ARHL plays a crucial role in improving their quality of life. At present, the use of hearing aids and cochlear implants are the main means to treat the daily hearing difficulties and communication difficulties of patients with ARHL. However, in China, due to the economy, the concept of not wanting to treat the elderly, and other reasons, the hearing aid wearing rate compared to developed countries has significant differences. Cochlear implant is another option for patients with presbyacusis, and patients can obtain good hearing and speech recognition rate after surgery. At present, there is no definitive conclusion on whether the quality of life of patients after cochlear implantation has been improved, and this study will be reviewed based on previous relevant reports.