Pre-operative and per-operative factors conditioning long-term facial nerve function in vestibular schwannoma surgery through translabyrinthine approach

1998 ◽  
Vol 112 (5) ◽  
pp. 441-445 ◽  
Author(s):  
Olivier Deguine ◽  
André Maillard ◽  
Alain Bonafe ◽  
Hassan El Adouli ◽  
Michel Tremoulet ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Internal Auditory Canal ◽  
Stage Iv ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Stimulation Threshold ◽  
Translabyrinthine Approach ◽  
Facial Function

AbstractFacial nerve function was evaluated in 103 patients, after vestibular schwannoma removal through the translabyrinthine approach. The mean follow-up was 43 months (minimum six months). Grade I facial function was achieved in 100 per cent of stage I schwannomata compared with 36 per cent of stage IV schwannomata. Grade I or II facial function was found in 78 per cent of homogeneous schwannomata, compared with 48 per cent of heterogeneous schwannomata. Facial function was preserved in 89 per cent of cases, if the angle between the internal auditory canal and the schwannoma was >66°, compared with 54 per cent if the angle was <66°. There was 82 per cent of normal facial function when the nerve appeared normal after tumour removal, compared with 18 per cent when the nerve was traumatized. When the ratio (stimulation threshold at the internal auditory canal/stimulation threshold at brainstem) was <2, postoperative facial function was preserved in 87 per cent of cases, compared with 13 per cent when the ratio was >2.

scholarly journals Long-term facial nerve clinical evaluation following vestibular schwannoma surgery

2008 ◽  
Vol 66 (2a) ◽  
pp. 194-198 ◽  
Author(s):  
Rafaela Julia Batista Veronezi ◽  
Yvens Barbosa Fernandes ◽  
Guilherme Borges ◽  
Ricardo Ramina
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Tumor Size ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Facial Function

BACKGROUND: Facial function is important in accompaniment of patients operated on vestibular schwannoma (VS). OBJETIVE: To evaluate long term facial nerve function in patients undergoing VS resection and to correlate tumor size and facial function in a long-term follow-up. METHOD: Transversal study of 20 patients with VS operated by the retrosigmoid approach. House-Brackmann Scale was used preoperatively, immediately after surgery and in a long-term follow-up. Student t test was applied for statistic analysis. RESULTS: In the immediate postoperative evaluation, 65% of patients presented FP of different grades. Improvement of facial nerve function (at least of one grade) occurred in 53% in the long-term follow-up. There was statistically significant difference in facial nerve outcome in long-term follow-up when tumor size was considered (p<0.05). Conclusion: The majority of patients had improvement of FP in a long-term follow-up and tumor size was detected to be a factor associated with the postoperative prognostic.

Facial Nerve Outcome after Acoustic Neuroma Surgery: A Study from the Era of Cranial Nerve Monitoring

1994 ◽  
Vol 111 (5) ◽  
pp. 561-570 ◽  
Author(s):  
Anil K. Lalwani ◽  
Fidelia Yuan-Shin Butt ◽  
Robert K. Jackler ◽  
Lawrence H. Pitts ◽  
Charles D. Yingling
Keyword(s):  
Facial Nerve ◽  
Nerve Stimulation ◽  
Cranial Nerve ◽  
Surgical Removal ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Stimulation Threshold ◽  
Nerve Monitoring ◽  
Facial Function

The introduction of intraoperative cranial nerve monitoring in posterior fossa surgery has greatly aided the surgeon in identification and anatomic preservation of cranial nerves. As a result, the long-term function of the facial nerve continues to improve after removal of acoustic neuroma. Herein, we report our long-term (1 year or greater) facial nerve outcome in 129 patients who underwent surgical removal of their acoustic neuromas with the aid of Intraoperative neurophysiologic monitoring between 1986 and 1990. The facial nerve was anatomically preserved in 99.2% of the patients, and 90% of all the patients had grade 1 or 2 facial nerve function 1 year after surgery. Long-term facial function was inversely correlated with the size of tumor (chi-squared, p < 0.02) and was not related to the side of tumor, the age and sex of the patient, or the surgical approach. In a comparison among tumor groups matched for size, no statistically significant difference in facial nerve outcome between the translabyrinthine and retrosigmoid approaches was detected. The proximal facial nerve stimulation threshold at the end of surgical removal was predictive of long-term facial nerve function (analysis of variance, p < 0.02). At 1 year, 98% (87 of 89) of the patients with electrical thresholds of 0.2 V or less had grade 1 or 2 facial nerve function compared with only 50% (8 of 16) of those with thresholds between 0.21 and 0.6 V. In the era of cranial nerve monitoring, patients can be better advised about long-term facial nerve outcome after surgical intervention. Preoperatively, the size of the tumor is the most critical factor in predicting long-term facial function. Postoperatively, the proximal seventh nerve stimulation threshold at the end of the surgical procedure can be used as one prognostic measure of long-term facial nerve function.

Predictive Factors of Early Postoperative and Long-Term Facial Nerve Function After Large Vestibular Schwannoma Surgery

2019 ◽  
Vol 127 ◽  
pp. e599-e608 ◽  
Author(s):  
Lucas Troude ◽  
Mohamed Boucekine ◽  
Marion Montava ◽  
Jean-Pierre Lavieille ◽  
Jean-Marie Régis ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Predictive Factors ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Large Vestibular Schwannoma

Prognostic factors of facial nerve function after vestibular schwannoma removal via translabyrinthine approach

2019 ◽  
Vol 139 (6) ◽  
pp. 541-546 ◽  
Author(s):  
Jungmin Ahn ◽  
Nam-Gyu Ryu ◽  
Jihyun Lim ◽  
Minwoong Kang ◽  
Ho Jun Seol ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Translabyrinthine Approach

scholarly journals Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy

2017 ◽  
Vol 79 (03) ◽  
pp. 309-313 ◽  
Author(s):  
Michael Mooney ◽  
Benjamin Hendricks ◽  
Christina Sarris ◽  
Robert Spetzler ◽  
Randall Porter ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Tumor Diameter ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Microsurgical Resection ◽  
Grade Iii

Objectives This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design A retrospective review. Setting Single-institution cohort. Participants Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures Incidence, House–Brackmann grade. Results Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2.4%. Seven of these nine patients had Koos grade 4 tumors. Mean tumor diameter was 3.0 cm (range: 2.1–4.4 cm), and seven of nine tumors were subtotally resected. All nine patients were followed up clinically for ≥ 6 months. Of the six patients with a preoperative House–Brackmann grade of II, two improved to grade I, three were stable, and one patient worsened to grade III. Of the three patients with grade III or worse, all remained stable at last follow-up. Conclusions Preoperative facial nerve palsy is rare in patients with vestibular schwannoma; it tends to occur in patients with relatively large lesions. Detailed long-term outcomes of facial nerve function after microsurgical resection for these patients have not been reported previously. We followed nine patients and found that eight (89%) of the nine patients had either stable or improved facial nerve outcomes after treatment. Management strategies varied for these patients, including rates of subtotal versus gross-total resection and the use of stereotactic radiosurgery in patients with residual tumor. These results can be used to help counsel patients preoperatively on expected outcomes of facial nerve function after treatment.

Preservation of Facial Nerve Function after Postoperative Vasoactive Treatment in Vestibular Schwannoma Surgery

Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. 577-584 ◽  
Author(s):  
Christian Strauss ◽  
Johann Romstöck ◽  
Rudolf Fahlbusch ◽  
Stefan Rampp ◽  
Christian Scheller
Keyword(s):  
Facial Nerve ◽  
Hydroxyethyl Starch ◽  
Vestibular Schwannoma ◽  
Complete Recovery ◽  
Potential Effect ◽  
Long Term Results ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Before And After

Abstract OBJECTIVE: Facial nerve paresis and hearing loss are common complications after vestibular schwannoma surgery. Experimental and clinical studies point to a beneficial effect of nimodipine and hydroxyethyl starch for preservation of cochlear nerve function. A retrospective analysis was undertaken to evaluate the effect of vasoactive treatment on facial nerve outcome. PATIENTS AND METHODS: Forty-five patients with vestibular schwannoma removal, intraoperative electromyographic monitoring, and postoperative deterioration of facial nerve function were evaluated. Twenty-five patients underwent vasoactive treatment consisting of nimodipine and hydroxyethyl starch for improvement of hearing outcome. Twenty patients did not receive such treatment. Facial nerve function was evaluated before and after surgery, as well as 1 year after the surgical procedure. Patients were comparable regarding age, tumor size, and preoperative facial nerve function. RESULTS: Long-term results of facial nerve function were significantly improved in those patients who experienced severe postoperative deterioration of facial nerve function and received vasoactive treatment as compared with patients who did not receive nimodipine and hydroxyethyl starch after surgery. Treated patients showed a significantly higher rate of complete recovery compared with patients without treatment. CONCLUSION: The study points to a potential effect of vasoactive treatment for facial nerve function after vestibular schwannoma surgery. In particular, patients with postoperative disfiguring facial nerve palsy clearly benefit from intravenous hydroxyethyl starch and nimodipine with respect to a long-term socially acceptable facial nerve function.

Predictive Factors of Long-term Facial Nerve Function after Vestibular Schwannoma Surgery

2002 ◽  
Vol 23 (3) ◽  
pp. 388-392 ◽  
Author(s):  
John E. Fenton ◽  
R. Y. Chin ◽  
P. A. Fagan ◽  
O. Sterkers ◽  
J. M. Sterkers
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Predictive Factors ◽  
Nerve Function ◽  
Facial Nerve Function

scholarly journals Delayed Facial Nerve Paralysis after Vestibular Schwannoma Resection

2018 ◽  
Vol 80 (03) ◽  
pp. 283-286
Author(s):  
Robert J. Yawn ◽  
Matthew M. Dedmon ◽  
Deborah Xie ◽  
Reid C. Thompson ◽  
Matthew R. O'Malley ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Surgical Resection ◽  
Vestibular Schwannoma ◽  
Retrospective Chart Review ◽  
Facial Nerve Paralysis ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Paralysis ◽  
The Mean

Objective To describe the incidence and clinical course of patients who develop delayed facial nerve paralysis (DFNP) after surgical resection of vestibular schwannoma. Setting Tertiary skull base center. Methods Retrospective chart review. Results Two hundred and forty six consecutive patients, who underwent surgical resection for vestibular schwannoma at a single center between 2010 and 2015, were analyzed. Of these patients, 22 (8.9%) developed DFNP, defined here as deterioration of function by at least 2 House–Brackmann (HB) grades within 30 days in patients with immediate postoperative HB ≤ 3. The mean age of DFNP patients was 47.2 years (range: 17–67) and 16 (73%) were female. The mean tumor size in greatest dimension was 2.1 cm (range: 0.7–3.5 cm). At the conclusion of each case, the facial nerve stimulated at the brainstem. Mean immediate postoperative facial nerve function was HB 1.8 (range: 1–3). Average facial nerve function at the 3-week-postoperative visit was 4.4 (range: 2–6). In 1-year, 8 patients (36%) recovered HB 1 function, 10 patients (46%) recovered to HB 2, and 2 patients (9%) were HB 3. The remaining 2 patients did not recover function and were HB 6 at last follow-up. Initial postoperative facial nerve function (HB 1 or HB 2) was associated with improved recovery to normal (HB 1) function (p = 0.018). Conclusion A majority of patients that develop delayed paralysis will recover excellent facial nerve function. Patients should be counseled; however, a small percentage of patients will not recover function long-term, despite having a previously functioning and anatomically intact nerve.

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