Prognostic clinical and radiological parameters for immediate facial nerve function following vestibular schwannoma surgery

Gerganov, Venelin Miloslavov; Klinge, Petra Margarete; Nouri, Mohsen; Stieglitz, Lennart; Samii, Madjid; Samii, Amir (2009). Prognostic clinical and radiological parameters for immediate facial nerve function following vestibular schwannoma surgery. Acta neurochirurgica, 151(6), 581-7; discussion 587. Wien: Springer 10.1007/s00701-009-0288-3

Preview

Text Gerganov2009_Article_PrognosticClinicalAndRadiologi.pdf - Published Version Available under License Publisher holds Copyright. Download (199kB) | Preview

OBJECTIVE: The paper aims to define the parameters available before surgery which could predict immediate facial nerve function after excision of a vestibular schwannoma (VS). METHODS: Ninety-nine patients with VS operated consecutively by a single surgeon using an identical surgical technique have been evaluated retrospectively. Data were collected regarding patients' sex, age at onset of symptoms and at surgery, initial symptoms, neurological status at presentation, early post-operative neurological status and complications. The main radiological parameters included in the study were tumour extension pattern, diameters, shape, and volume, as well as extent of bony changes of the internal auditory canal. RESULTS: As the tumour stage and volume increase, facial nerve function is worse after surgery (p < 0.001 and p < 0.05, respectively). Concomitantly, larger extra-meatal tumour diameters in three dimensions (sagittal, coronal and axial) led to worse function (p < 0.01). Anterior and/or caudal tumour extension (p = 0.001 and p = 0.004, respectively) had more significant correlation than posterior and/or cranial extension (p = 0.022 and p = 0.353, respectively). Polycyclic VS had the worst prognosis, followed by the tumours with oval shape. The extent of intra-meatal tumour growth does not correlate with immediate facial nerve outcome. The different angles, lengths and diameters of the internal auditory channel showed no significant correlation with facial nerve outcome. Patients with headache as an initial symptom and those with gait instability and/or pre-operative poor facial nerve function had significantly worse immediate facial nerve outcome. CONCLUSION: Our data suggests that the analysis of the radiological and neurological patient data prior to surgery could give reliable clues regarding the immediate post-operative facial nerve function.

Interest & Impact

Downloads

239 since deposited on 04 Oct 2013
38 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item