Prognostic Factors for the Outcome of Translabyrinthine Surgery for Vestibular Schwannomas.
Otol Neurotol
; 42(3): 475-482, 2021 03 01.
Article
en En
| MEDLINE
| ID: mdl-33165159
ABSTRACT
OBJECTIVE:
To identify predictors of tumor recurrence and postoperative facial nerve function after translabyrinthine surgery for unilateral vestibular schwannomas. STUDYDESIGN:
Retrospective study.SETTING:
Tertiary referral center. PATIENTS Between 1996 and 2017 a total of 596 patients with unilateral vestibular schwannoma underwent translabyrinthine surgery. Pre- and postoperative clinical status, radiological, and surgical findings were evaluated.INTERVENTIONS:
Translabyrinthine surgery. MAIN OUTCOMEMEASURES:
Potential predictors for tumor recurrence and facial nerve outcome were analyzed using Cox regression and ordinal logistic regression, respectively.RESULTS:
The extent of tumor removal was total in 32%, near-total in 58%, and subtotal in 10%. In 5.5% (33/596) of patients the tumor recurred. Subtotal tumor resection (pâ=â0.004, hazard ratios [HR]â=â10.66), a young age (pâ=â0.008, HRâ=â0.96), and tumor progression preoperatively (pâ=â0.042, HRâ=â2.32) significantly increased the risk of recurrence, whereas tumor size or histologic composition did not. A good postoperative facial nerve function (House-Brackmann grade 1-2) was achieved in 85%. The risk of postoperative facial nerve paresis or paralysis increased with tumor size (pâ<â0.001, ORâ=â1.52), but was not associated with the extent of tumor removal, histologic composition, or patient demographics.CONCLUSIONS:
Translabyrinthine surgery is an effective treatment for vestibular schwannoma, with a good local control rate and facial nerve outcome. The extent of tumor removal is a clinically relevant predictor for tumor recurrence, as are young patient age and preoperative tumor progression. A large preoperative tumor size is associated with a higher risk of postoperative facial nerve paresis or paralysis.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neuroma Acústico
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Otol Neurotol
Asunto de la revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Año:
2021
Tipo del documento:
Article