Intraoperative monitoring and early recognition of facial nerve root in vestibular schwannoma surgery.
Humans
Neuroma, Acoustic
/ surgery
Male
Female
Middle Aged
Adult
Facial Nerve
Aged
Monitoring, Intraoperative
/ methods
Retrospective Studies
Neurosurgical Procedures
/ methods
Treatment Outcome
Facial Paralysis
Intraoperative Neurophysiological Monitoring
/ methods
Facial Nerve Injuries
/ prevention & control
Young Adult
Facial nerve palsy
House-Brackmann scale
Intraoperative neuromonitoring
Vestibular schwannoma
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
15 Oct 2024
15 Oct 2024
Historique:
received:
09
08
2024
accepted:
03
10
2024
revised:
14
09
2024
medline:
15
10
2024
pubmed:
15
10
2024
entrez:
14
10
2024
Statut:
epublish
Résumé
The removal of vestibular schwannomas carries a risk of facial palsy. This study aims to evaluate the usefulness and technical aspects of intraoperative monitoring (IOM) for the facial nerve. A total of 96 patients who underwent surgery for vestibular schwannoma were retrospectively investigated. The cohort was divided into two groups: those with intraoperative facial nerve monitoring (IOM group) and those without IOM (non-IOM group). Preoperative and postoperative facial nerve functions were assessed using the House-Brackmann (HB) scale immediately after surgery, at discharge, and at the 1-year follow-up. HB grade I and II were classified as satisfactory outcomes, HB grade III and IV as intermediate, and HB grade V and VI as poor. Facial nerve functions were compared between the groups. Additionally, the ratio of satisfactory results was investigated in the IOM group, focusing on whether the root exit zone (REZ) was identified at an early or late stage of surgery. Among the 65 (67%) patients in the IOM group and 31 (32%) patients in the non-IOM group, there were no differences in demographic and tumor characteristics. The extent of resection varied from subtotal to gross total removal, with no statistical differences between the groups. Although facial nerve function was more favorably preserved in the non-IOM group immediately after surgery, this trend reversed at discharge and the 1-year follow-up, showing significant statistical differences. In the IOM group, more patients achieved satisfactory outcomes when the REZ was identified early compared to late during tumor resection. Intraoperative facial nerve monitoring provides more satisfactory outcomes in preserving nerve function in vestibular schwannoma surgery. Early recognition of the REZ may contribute to improved surgical outcomes.
Identifiants
pubmed: 39402283
doi: 10.1007/s10143-024-03017-4
pii: 10.1007/s10143-024-03017-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
798Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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