Efficacy of facial nerve-sparing approach in patients with vestibular schwannomas.
J Neurosurg
; 115(5): 917-23, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-21854113
ABSTRACT
OBJECT The goal of this article was to show that a combination of facial nerve-sparing microsurgical resection and Gamma Knife surgery (GKS) for expansion of any residual tumor can preserve good facial nerve function in patients with recurrent vestibular schwannoma (VS). METHODS:
Records of individuals treated by a single surgeon with a facial nerve-sparing technique for a VS between 1998 and 2009 were retrospectively analyzed for tumor recurrence. Of the 383 patients treated for VS, 151 underwent microsurgical resection, and 20 (13.2%) of these patients required postoperative retreatment for a significant expansion of residual tumor after microsurgery. These 20 patients were re-treated with GKS.RESULTS:
The rate of preservation of good facial nerve function (Grade I or II on the House-Brackmann scale) in patients treated with microsurgery for VS was 97%. Both subtotal and gross-total resection had excellent facial nerve preservation rates (97% vs 96%), although subtotal resection carried a higher risk that patients would require retreatment. In patients re-treated with GKS after microsurgery, the rate of facial nerve preservation was 95%.CONCLUSIONS:
In patients with tumors that cannot be managed with radiosurgery alone, a facial nerve-sparing resection followed by GKS for any significant regrowth provides excellent facial nerve preservation rates.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neuroma Acústico
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Radiocirurgia
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Traumatismos do Nervo Facial
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Nervo Facial
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Microcirurgia
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:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article