Transient Subacute Facial Nerve Dysfunction After Dual Modality Treatment of Large Vestibular Schwannomas.
Otol Neurotol
; 42(2): e209-e215, 2021 02 01.
Article
em En
| MEDLINE
| ID: mdl-33229880
ABSTRACT
OBJECTIVES:
1 Describe subacute facial nerve paralysis after salvage stereotactic radiosurgery (SRS). 2 To analyze predictors of facial nerve weakness after dual modality treatment. PATIENTS Adult patients with Vestibular Schwannoma who underwent sub-total resection (STR) followed by salvage radiation.INTERVENTIONS:
Microsurgical resection of VS, stereotactic radiosurgery, intensity-modulated radiotherapy, proton radiotherapy. MAIN OUTCOMEMEASURES:
Serial facial nerve function (House-Brackmann scale).RESULTS:
Thirteen patients who underwent dual modality treatment for large VS were included (mean ageâ=â43.6 years, 77% females). The mean pre-operative tumor volume was 11.7âcm3 (SDâ=â6.5) and the immediate mean post-operative remnant volume was 1.5âcm3 (SDâ=â1.4) with a mean extent of resection of 86.7% (SDâ=â9.5). The mean salvage-free interval was 20.8 months (SDâ=â13.3). All patients had excellent one-year FN outcome (HB grade 1, 2) after resection. Three patients developed subacute facial nerve weakness after salvage SRS (4.2-9.4 months after SRS). This paralysis responded to high dose systemic steroids and no surgical interventions for facial rehabilitation were required. At last follow up (mean 61.6 months, SDâ=â28.5), facial nerve function was favorable (HB grade 1-2 in 12 patients and HB grade 3 in 1 patient). There were no significant associations between various predictors and subacute deterioration of facial nerve function after SRS.CONCLUSIONS:
Sub-acute transient facial nerve dysfunction can develop infrequently over a variable time frame after post-operative salvage SRS and usually responds to steroids. Patients should be adequately counseled about potential of transient deterioration of facial nerve function after salvage SRS.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neuroma Acústico
/
Radiocirurgia
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article