Care Before and After Surgery for Auditory Neuroma

1, preoperative preparation: patients should assist the doctor to do a good job of preoperative examinations, preoperative family members of patients should be given to patients with high calorie, high protein, high vitamin, easy to digest diet, in order to replenish the patient’s body consumption, increase the body’s resistance to improve the tolerance of the operation, and to promote the postoperative incision healing as soon as possible. For patients with increased intracranial pressure, they should be instructed to reduce their activity and take bed rest. 2, postoperative care: position is very important for postoperative patients, negligence will bring irreparable loss to the patient. Specific practices are as follows: (1) postoperative movement of patients must be gentle and smooth, need a person with both hands to support the patient’s head, to prevent the head and neck twisted or vibration. (2) general anesthesia is not awake to take the horizontal position, head inclined to the healthy side, head pillow cold water bag to reduce and prevent intracranial hemorrhage. When the patient is awake and the blood pressure is stable, the head of the bed is elevated by 15°-30°, which is conducive to intracranial venous return, reduce cerebral edema, and lower intracranial pressure. (3) If the patient’s tumor volume is large and there is a large void in the cranial cavity after surgery, the patient should take the healthy side lying position. It is forbidden to turn the head within 24h after surgery to prevent sudden displacement of the brainstem, which may cause respiratory and cardiac arrest. After 24h, the patient can turn over, but the head should be moved with great care, even if it is several days after the surgery, the head should be turned over very gently and slowly, and the head should be turned at the same time with the body. (1) Hearing loss: it is related to the compression of the auditory nerve by the tumor. Therefore, the family members of the patients should talk with the patients patiently, understand the patients’ needs, satisfy the patients’ requirements in life, and answer the questions until the patients understand them, supplemented with gestures and words if necessary, so as to enhance the patients’ confidence in overcoming the disease. (2) Facial nerve injury: Facial nerve injury is one of the main complications after auditory neuroma surgery, patients’ eyelid closure is incomplete or can’t be closed at all, and corneal ulcers are easy to occur, even blindness, family members should give chloramphenicol eye drops and apply gentamycin ophthalmic ointment, wear eye shields to protect the eyes during daytime, and cover them with petroleum jelly gauze to keep dust and moisturize them during nighttime sleep. Patients with loss of facial sensation should be prevented from burns when eating, and the affected side should be prohibited from hot and cold compresses and irritating medicines. Patients with crooked corners of the mouth can massage the affected side of the face for a week after the operation, and the patients should often do opening the mouth, puffing out the cheeks, blowing and other movements, and with acupuncture treatment can make the condition relieved. (3) Risk of brain stem displacement: after tumor removal, local cavity is formed, brain tissue cannot be quickly reset, excessive moving of head may cause brain stem to move to the surgical cavity and lead to respiratory arrest. Family members should not move the head excessively when the patient turns over after 24 hours of operation, pay attention to the simultaneous rotation of the head and the body, avoid twisting the neck and suddenly turning over to the healthy side, and observe the changes of respiration, pulse, blood pressure, and pupil after turning over, and report to the doctor in time if shortness of breath is found. (4) Posterior cranial nerve injury: Postoperative auditory neuroma, especially large auditory neuroma, is often accompanied by posterior cranial nerve injury, and the patient will have hoarseness, choking, difficulty in swallowing, weakness in coughing, difficulty in active sputum expectoration, which will easily cause respiratory tract obstruction and pulmonary complications. At this time, we should follow the requirements of doctors and nurses to provide dietary guidance and strengthen respiratory care, and try to feed water after 3d postoperative fasting, and then give fluids if meta-choking, and then gradually give semi-fluids, and give high-protein, high-vitamin, high-calorie, easy-to-digest nasogastric fluids to those who choked, and then give general diets to the patients according to the patients’ recovery situation after 2 weeks.