Are Facial Nerve Outcomes Worse Following Surgery for Cystic Vestibular Schwannoma?

ABSTRACT

Objectives: This study sought to determine explicitly whether postsurgical facial nerve outcomes for patients with a cystic component to a vestibular schwannoma were significantly different from those with a solid tumor. Design: Seventy patients who underwent translabyrinthine surgery for a cystic vestibular schwannoma between May 1981 and the present, and who had complete records in our database, were identified. These were compared with a group of patients with solid tumors matched to the study group on the following parameters: House-Brackmann grade at presentation, tumor size, surgical approach, age. Setting: Regional tertiary referral center. Participants: Adult patients with vestibular schwannomas. Main Outcome Measures: House-Brackmann score 2 years following surgery. Results: No significant difference was found between the two groups. Conclusions: The perceived difference in outcomes between cystic and solid vestibular schwannomas cannot be demonstrated when confounding factors such as tumor size are taken into account.

KEYWORDS

Vestibular schwannoma - facial nerve - outcome measures

REFERENCES

• 1 Wallace C J, Fong T C, Auer R N. Cystic intracranial schwannoma.  Can Assoc Radiol J. 1993;  44 453-459
• 2 Jeng C M, Huang J S, Lee W Y et al.. Magnetic resonance imaging of acoustic schwannomas.  J Formos Med Assoc. 1995;  94 487-493
• 3 Charabi S. Acoustic neuroma/vestibular schwannoma in vivo and in vitro growth models. A clinical and experimental study.  Acta Otolaryngol Suppl. 1997;  530 1-27
• 4 Charabi S, Tos M, Borgesen S E, Thomsen J. Cystic acoustic neuromas. Results of translabyrinthine surgery.  Arch Otolaryngol Head Neck Surg. 1994;  120 1333-1338
• 5 Fundová P, Charabi S, Tos M, Thomsen J. Cystic vestibular schwannoma: surgical outcome.  J Laryngol Otol. 2000;  114 935-939
• 6 Wandong S, Meng L, Xingang L et al.. Cystic acoustic neuroma.  J Clin Neurosci. 2005;  12 253-255
• 7 Tali E T, Yuh W T, Nguyen H D et al.. Cystic acoustic schwannomas: MR characteristics.  AJNR Am J Neuroradiol. 1993;  14 1241-1247
• 8 Lanser M J, Jackler R K, Pitts L H. Intratumoral hemorrhage and cyst expansion as causes of acute neurological deterioration in acoustic neuroma patients. In: Tos M, Thomsen J Acoustic Neuroma. 1st ed. Amsterdam, NY; Kugler Publications 1992: 229-234
• 9 Zaouche S, Ionescu E, Dubreuil C et al.. Pre- and intraoperative predictive factors of facial palsy in vestibular schwannoma surgery.  Acta Otolaryngol. 2005;  125 363-369
• 10 Grey P L, Moffat D A, Palmer C R et al.. Factors which influence the facial nerve outcome in vestibular schwannoma surgery.  Clin Otolaryngol. 1996;  21 409-413
• 11 House J W, Brackmann D E. Facial nerve grading system.  Otolaryngol Head Neck Surg. 1985;  93 146-147
• 12 R Development Core Team .R a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. 2005 Available at: http://www.R-project.org
• 13 Deguine O, Maillard A, Bonafe A et al.. Pre-operative and peri-operative factors conditioning long-term facial nerve function in vestibular schwannoma surgery through translabyrinthine approach.  J Laryngol Otol. 1998;  112 441-445