Factors associated with preservation of facial nerve function after surgical resection of vestibular schwannoma

• DOI: 10.1007/s11060-010-0315-5
• Publication Date: 2010-08-05T11:17:54Z
• Authors: Orin Bloch; Michael E. Sughrue; Rajwant Kaur; Ari J. Kane; Martin J. Rutkowski; Gurvinder Kaur; Isaac Yang; Lawrence H. Pitts; Andrew T. Parsa
• Keywords: Male; Microsurgery; Cancer Research; Neoplasm, Residual; Clinical Sciences; Oncology and Carcinogenesis; Clinical Neurology; 610; Facial nerve function; Neuroma; 03 medical and health sciences; Vestibular schwannoma; Postoperative Complications; 0302 clinical medicine; Clinical Research; 616; Humans; Oncology & Carcinogenesis; Acoustic; Cancer; Retrospective Studies; Clinical Study - Patient Studies; Biomedical and Clinical Sciences; Acoustic neuroma; Neurosciences; Evaluation of treatments and therapeutic interventions; Oncology and carcinogenesis; Neuroma, Acoustic; Middle Aged; Brain Disorders; Survival Rate; Facial Nerve; Treatment Outcome; Facial nerve palsy; Oncology; Neurology; Residual; Neoplasm; Female; Facial Nerve Diseases; 6.4 Surgery; Follow-Up Studies

Avoidance of facial nerve palsy is one the major goals vestibular schwannoma (VS) microsurgery. In this study, we examined significance previously implicated prognostic factors (age, tumor size, extent resection and surgical approach) on post-operative function. We selected all VS patients from prospectively collected database (1984-2009) who underwent microsurgical as their initial treatment for histopathologically confirmed VS. The effect variables such approach, patient age rates dysfunction after surgery, were analyzed using multivariate logistic regression. Patients with preoperative (House-Brackman [HB] score 3 or higher) excluded, HB grade 1 2 at last follow-up visit was defined "facial preservation." A total 624 included in study. Multivariate regression analysis found that only pre-operative size significantly predicted poorer outcome followed-up ≥6 ≥12 months (OR 1.27, 95% CI 1.09-1.49, p < 0.01; OR 1.35, 1.10-1.67, P 0.01, respectively). no significant relationship between function age, resection, (when approach analysis). Because a debilitating psychologically devastating condition patient, suggest altering aggressiveness unfavorable anatomy, particularly cases large tumors where overaggressive might subject to unwarranted risk. Residual disease can be followed controlled radiosurgery if interval growth noted.