H Wu1, J Sterkers. 1. Professeur Honoraire au Collège de Médecine, Hôpitaux de Paris, 4 rue Michel-Ange, 75016, Paris, France. wuhao622@public7.sta.net.cn
Abstract
OBJECTIVE: the authors reviewed the clinical manifestations and the surgical outcomes in a series of young patients who underwent removal of large acoustic neuromas via the translabyrinthine approach. METHODS: 40 young adults who underwent a translabyrinthine removal of acoustic neuromas 3 cm or greater in size were analyzed. The patient's age ranged from 17 to 30 years. The mean size of tumor was 4.25 cm. RESULTS: the primary symptoms are similar to those in adult but usually less intense. The average interval time between the primary symptom and the diagnosis was 17 months. A high percentage of preoperative normal hearing (35%) and good facial function (100%) were noted. Translabyrinthine approach was used in all cases. Total removal was realised in 39 patients (97.5%). The facial nerve was anatomically preserved in 37 patients (92.5%). Twenty-six patients (65%) had a good facial function (House-Brackmann grade I or II) immediately or at 1 month after surgery, 11 patients (28%) achieved grade III or IV. Three patients underwent an immediate nerve repair after tumor removal. All of them recovered to grade III or IV 1 year after surgery. Postoperative complications were minimal. CONCLUSIONS: young adults may have a rapid growth rate but usually have minimal symptoms even with a large acoustic neuroma. The translabyrinthine approach has been used successfully in removal of large acoustic tumors of young patients, with the good result of facial nerve preservation and long-term tumor control.
OBJECTIVE: the authors reviewed the clinical manifestations and the surgical outcomes in a series of young patients who underwent removal of large acoustic neuromas via the translabyrinthine approach. METHODS: 40 young adults who underwent a translabyrinthine removal of acoustic neuromas 3 cm or greater in size were analyzed. The patient's age ranged from 17 to 30 years. The mean size of tumor was 4.25 cm. RESULTS: the primary symptoms are similar to those in adult but usually less intense. The average interval time between the primary symptom and the diagnosis was 17 months. A high percentage of preoperative normal hearing (35%) and good facial function (100%) were noted. Translabyrinthine approach was used in all cases. Total removal was realised in 39 patients (97.5%). The facial nerve was anatomically preserved in 37 patients (92.5%). Twenty-six patients (65%) had a good facial function (House-Brackmann grade I or II) immediately or at 1 month after surgery, 11 patients (28%) achieved grade III or IV. Three patients underwent an immediate nerve repair after tumor removal. All of them recovered to grade III or IV 1 year after surgery. Postoperative complications were minimal. CONCLUSIONS: young adults may have a rapid growth rate but usually have minimal symptoms even with a large acoustic neuroma. The translabyrinthine approach has been used successfully in removal of large acoustic tumors of young patients, with the good result of facial nerve preservation and long-term tumor control.
Authors: Daniele Starnoni; Lorenzo Giammattei; Giulia Cossu; Michael J Link; Pierre-Hugues Roche; Ari G Chacko; Kenji Ohata; Majid Samii; Ashish Suri; Michael Bruneau; Jan F Cornelius; Luigi Cavallo; Torstein R Meling; Sebastien Froelich; Marcos Tatagiba; Albert Sufianov; Dimitrios Paraskevopoulos; Idoya Zazpe; Moncef Berhouma; Emmanuel Jouanneau; Jeroen B Verheul; Constantin Tuleasca; Mercy George; Marc Levivier; Mahmoud Messerer; Roy Thomas Daniel Journal: Acta Neurochir (Wien) Date: 2020-07-29 Impact factor: 2.216