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J Neurol Surg B Skull Base 2012; 73(01): 021-027
DOI: 10.1055/s-0032-1304559
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Facial Nerve Outcome after Vestibular Schwannoma Surgery: Our Experience[*]

Vittorio Rinaldi
1   Area of Otolaryngology;
,
Manuele Casale
1   Area of Otolaryngology;
,
Federica Bressi
2   Area of Neurology, Campus Bio-Medico University;
,
Massimiliano Potena
1   Area of Otolaryngology;
,
Emanuela Vesperini
1   Area of Otolaryngology;
,
Antonio De Franco
3   Rome American Hospital;
,
Sergio Silvestri
4   Faculty of Biomedical Engineering, Campus Bio-Medico University, Rome, Italy.
,
Carlo Zini
3   Rome American Hospital;
,
Fabrizio Salvinelli
1   Area of Otolaryngology;
› Author Affiliations
Further Information

Publication History

11 August 2010

10 August 2011

Publication Date:
24 February 2012 (online)

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Facial Nerve Outcome after Vestibular Schwannoma Surgery: Our ExperienceSkull Base 2011; 21(S 02): e8-e8
DOI: 10.1055/s-0031-1296039

Abstract

In this study we evaluate the postoperative facial nerve function after vestibular schwannoma (VS) surgery and analyze the factors that cause it. We included 97 consecutive patients undergoing surgical excision of sporadic unilateral VS. Patient and tumor characteristics, surgical approaches, facial nerve function, extent of tumor removal, perioperative complications are all analyzed through standardized systems. Four different surgical approaches are used: translabyrinthine, retrolabyrinthine, retrosigmoid, and middle cranial fossa. Anatomic preservation of the facial nerve is achieved in 97% of patients. The incidence of postoperative facial palsy is found to be statistically correlated to tumor size, but not to the surgical approach used and to extent of tumor penetration in the internal auditory canal. A significant improvement of the short-term facial nerve outcome is detected in patients undergone simultaneous intraoperative electromyography (EMG) and pneumatic facial nerve monitoring. Complete tumor excision is achieved in 94% of cases. Complication rates are excellent and no deaths are reported. Short- and long-term facial nerve outcome is good and comparable with those of other series reported in literature. In VS surgery both EMG and pneumatic facial nerve monitors should be simultaneously used. Further investigations are desirable to improve the facial outcome respecting the oncological radicality.

Keywords

vestibular schwannoma surgery - acoustic neuroma surgery - facial nerve monitoring - facial nerve palsy

* This article was originally Published online in Skull Base on December 1, 2011 (DOI:10.1055/s-0031-1296039)


 

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