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

Published online by Cambridge University Press:  29 June 2007

Olivier Deguine ,
André Maillard ,
Alain Bonafe ,
Hassan El Adouli ,
Michel Tremoulet  and
Bernard Fraysse
Olivier Deguine*
Affiliation:
Department of Otolaryngology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
André Maillard
Affiliation:
Department of Neurosurgery, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Alain Bonafe
Affiliation:
Departments of Neuroradiology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Hassan El Adouli
Affiliation:
Department of Otolaryngology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Michel Tremoulet
Affiliation:
Department of Neurosurgery, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Bernard Fraysse
Affiliation:
Department of Otolaryngology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
*
Address for correspondence: Olivier Deguine, ENT Department, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Place du Docteur Baylac, 31059 Toulouse Cédex, France. Fax: +33 05 61 49 36 44 e-mail: [email protected]
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Abstract

Facial 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.

Keywords

Vestibular schwannomaSurgery, operativeFacial nerve
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 5 , May 1998 , pp. 441 - 445
Copyright
Copyright © JLO (1984) Limited 1998

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References

Arriaga, M. A., Long, S., Nelson, R. (1993a) Clinical correlations of acoustic neuroma volume. American Journal of Otology 14: 465–468.Google ScholarPubMed
Arriaga, M. A., Luxford, W. M., Atkins, J. S. Jr., Kwartler, J. A. (1993b) Predicting long-term facial nerve outcome after acoustic neuroma surgery. Otolaryngology – Head and Neck Surgery 108: 220–224.CrossRefGoogle ScholarPubMed
Beck, D. L., Atkins, J. S. Jr., Benecke, J. E. Jr., Brackmann, D. E. (1991) Intraoperative facial nerve monitoring: prognostic aspects during acoustic tumor removal. Otolaryngology – Head and Neck Surgery 104: 780–782.CrossRefGoogle ScholarPubMed
Berges, C., Fraysse, B., Yardeni, E., Rugiu, G. (1993) Intraoperative facial nerve monitoring in posterior fossa surgery: prognostic value. Skull Base Surgery 3: 214–216.CrossRefGoogle ScholarPubMed
Kartush, J. M., Niparko, J. K., Graham, M. D., Kemink, J. L. (1987) Electroneurography: preoperative facial nerve assessment for tumors of the temporal bone. Otolaryngology – Head and Neck Surgery 97: 257–261.CrossRefGoogle ScholarPubMed
Kirkpatrick, P. J., Watters, G., Strong, A. J., Walliker, J. R., Gleeson, M. J. (1991) Prediction of facial nerve function after surgery for cerebellopontine angle tumors: use of a facial nerve stimulator and monitor. Skull Base Surgery 1: 171–176.CrossRefGoogle ScholarPubMed
Lalwani, A. K., Butt, F. Y., Jackler, R. K., Pitts, L. H., Yingling, C. D. (1994) Facial nerve outcome after acoustic neuroma surgery: a study from the era of cranial nerve monitoring. Otolaryngology – Head and Neck Surgery 111: 561–570.CrossRefGoogle ScholarPubMed
Moffat, D. A., Croxson, G. R., Baguley, D. M., Hardy, D. G. (1989) Facial nerve recovery after acoustic neuroma removal. Journal of Laryngology and Otology 103:169–172.CrossRefGoogle ScholarPubMed
Moulin, G., Dessi, P., Andre, P., Cannoni, M., Pellet, W., Zanaret, M., Emram, B., Chagnand, G., Giusano, B., Bartoli, J.-M. (1995) Role of magnetic resonance imaging in predicting late facial motor function after removal of vestibular schwannomas by the translabyrinthine approach. Journal of Laryngology and Otology 109: 394–398.CrossRefGoogle ScholarPubMed
Prasad, S., Hirsch, B. E., Kamerer, D. B., Durrant, J., Sekhar, L. N. (1993) Facial nerve function following cerebellopontine angle surgery: prognostic value of electroneurography. American Journal of Otology 14: 326–329.Google ScholarPubMed
Ruth, H. R., Luetje, C. M., Whittaker, C. K. (1985) Acoustic tumors: preoperative measurement and correlation with postoperative facial nerve function. Otolaryngology – Head and Neck Surgery 93: 160–163.CrossRefGoogle ScholarPubMed
Silverstein, H., Rosenberg, S. I., Flanzer, J., Seidman, M. D. (1993) Intraoperative facial nerve monitoring in acoustic neuroma surgery. American Journal of Otology 14: 524–532.Google ScholarPubMed
Silverstein, H., Willcox, T. O. Jr., Rosenberg, S. I., Seidman, M. D. (1994) Prediction of facial nerve function following acoustic neuroma resection using intraoperative facial nerve stimulation. Laryngoscope 104: 539–544.CrossRefGoogle ScholarPubMed
Sterkers, J. M., Morrison, G. A., Sterkers, O., El-Dine, M. M. (1994) Preservation of facial, cochlear, and other nerve functions in acoustic neuroma treatment. Otolaryngology – Head and Neck Surgery 110: 146–155.CrossRefGoogle ScholarPubMed
Thomsen, J., Zander Olsen, P., Tos, M. (1985) Pre- and postoperative facial nerve testing in patients with acoustic neuromas. Acta Otolaryngologica (Stockh) 99: 239–244.CrossRefGoogle ScholarPubMed
Tos, M., Youssef, M., Thomsen, J., Turgut, S. (1992) Causes of facial nerve paresis after translabyrinthine surgery for acoustic neuroma. Annals of Otology, Rhinology and Laryngology 101: 821–826.CrossRefGoogle ScholarPubMed