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

Abstract

Background: Prediction of facial function is a major concern when proposing surgery for patients with vestibular schwannoma (VS).

Aims/objectives: To evaluate postoperative facial function of patients who underwent operation of VS via a translabyrinthine approach (TL), and to analyze factors that influence facial functions.

Material and methods: A total of 91 VS patients, who were operated via a TL approach, between March 1997 and December 2016, were analyzed. Demographics, tumor-related factors, and operative findings were collected. Facial function was assessed according to the House-Brackmann (HB) grading system before surgery, immediately after surgery, and 1-, 3-, 6-months, and 1 year after surgery.

Results: In cases of patients that had a tumor that extended to the CPA, an unsatisfactory facial outcome was noted in 12 (30.0%) patients. FN outcomes after tumor removal depend on tumor size (p = .040). Among FN-related factors, only the FN recovery timing was correlated with facial outcomes (p = .030). Univariable and multivariable analysis revealed that tumor size and the timing of FN recovery were significant as favorable prognostic factors for good facial outcomes.

Conclusions and significance: Tumor size and the FN recovery timing are significant prognostic factors of facial outcome in VS patients who underwent operations via a TL approach.

Chinese abstract

背景：在为前庭神经鞘瘤（VS）患者建议手术治疗时, 预测面部功能是一个主要问题。

目的：评估通过经迷路入路（TL）接受VS手术的患者的术后面部功能, 并分析影响面部功能的因素。

材料和方法：分析1997年3月至2016年12月期间接受TL法手术的共91名VS患者。收集了人口学资料、肿瘤相关因素和手术结果。在手术前、手术结束时以及手术后1个月、3个月、6个月和1年之时, 根据House-Brackmann（HB）分级系统评估面部功能。

结果：对于肿瘤扩展至CPA的患者, 12名（30.0％）患者的面部结果不令人满意。肿瘤切除后的FN结果取决于肿瘤大小（p = .040）。在FN相关因素中, 只有FN恢复时间与面部结果相关（p = .030）。单变量和多变量分析显示, 肿瘤大小和FN恢复时间显然是良好面部结果的有利预后因素。

结论和意义：肿瘤大小和FN恢复时间是接受TL法手术的VS患者的面部结果的重要预后因素。

Keywords:

• Facial palsy
• vestibular schwannoma
• translabyrinthine surgery
• outcome

Disclosure statement

No potential conflict of interest was reported by the authors.