Predicting Long-Term Facial Nerve Outcomes After Resection of Vestibular Schwannoma.
Otol Neurotol
; 41(10): e1328-e1332, 2020 12.
Article
em En
| MEDLINE
| ID: mdl-33492809
ABSTRACT
OBJECTIVES:
1) Describe the effect of tumor size on facial nerve (FN) outcomes after microsurgical resection of vestibular schwannoma (VS).2) Describe the effect of surgical approach, preoperative radiation, and early postoperative facial function on long-term FN outcomes. STUDYDESIGN:
Retrospective analysis.SETTING:
Tertiary referral center. PATIENTS Adult (≥18 yr) patients underwent translabyrinthine or retrosigmoid VS resection by a single neurotologist and single neurosurgeon between February 2008 and December 2017. MAIN OUTCOMEMEASURES:
Long-term FN outcomes (≥12 mo) according to House-Brackmann (HB) grade.RESULTS:
During the study period, 350 patients underwent VS resection, of whom 290 met inclusion criteria. Translabyrinthine surgery was performed in 54% (nâ=â158) and retrosigmoid in 45% (nâ=â131). One patient underwent a combined approach. Among patients who underwent retrosigmoid approach, none had a tumor more than 30âmm. Gross total resection was achieved in 98% (nâ=â283). Long-term HB1-2 function was achieved in 90% (nâ=â261). On univariate analysis, tumor size (per cm increase), history of preoperative radiation, and worse HB score at discharge predicted worse FN function. Multivariate analysis showed that tumor size (per cm increase) and history of radiation were independent predictors of FN function. For patients with tumors less than 30âmm, multivariate analysis of tumor size and surgical approach was performed; tumor size remained predictive of worse FN function (odds ratio [OR] 2.362, pâ=â0.0035), whereas surgical approach was not significantly predictive (pâ=â0.7569).CONCLUSION:
Tumor size and history of radiation predict long-term FN function after VS resection. When accounting for tumor size, the translabyrinthine and retrosigmoid approaches yield equivalent FN results.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neuroma Acústico
/
Traumatismos do Nervo Facial
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Otol Neurotol
Assunto da revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article