D A Moffat1, R A Parker2, D G Hardy3, R Macfarlane3. 1. Neuro-otology and Skull Base Surgery Department, Addenbrookes Hospital,Cambridge University Teaching Hospitals NHS Trust,UK. 2. Centre for Applied Medical Statistics,University of Cambridge,UK. 3. Neurosurgery Department, Addenbrookes Hospital,Cambridge University Teaching Hospitals NHS Trust,UK.
Abstract
OBJECTIVE: To determine factors affecting facial nerve outcome of vestibular schwannoma surgery. METHODS: This retrospective cohort study comprised 652 patients. The outcome measure was House-Brackmann classification at two years post-operatively. Univariate and multivariate analyses were carried out to determine the factors affecting facial nerve outcome. The incidence rates of hemifacial spasm, metallic taste and crocodile tear syndrome were recorded. RESULTS: For tumours less than 1.5 cm, 95 per cent of outcomes were normal, 100 per cent were satisfactory (House-Brackmann grades I-III) and 0 per cent were unsatisfactory (grades IV-VI). For tumours 1.5-2.4 cm, 83 per cent of outcomes were normal, 99 per cent were satisfactory and 1 per cent were unsatisfactory. For tumours 2.5-3.4 cm, 68 per cent of outcomes were normal, 96 per cent were satisfactory and 4 per cent were unsatisfactory. For tumours 3.5-4.4 cm, 52 per cent of outcomes were normal, 80 per cent were satisfactory and 20 per cent were unsatisfactory. For tumours larger than 4.4 cm, 50 per cent of outcomes were normal, 72 per cent were satisfactory and 28 per cent were unsatisfactory. CONCLUSION: Tumour size and operation year were significant predictors of facial nerve outcome. The surgical learning curve was steepest for the first 50 patients.
OBJECTIVE: To determine factors affecting facial nerve outcome of vestibular schwannoma surgery. METHODS: This retrospective cohort study comprised 652 patients. The outcome measure was House-Brackmann classification at two years post-operatively. Univariate and multivariate analyses were carried out to determine the factors affecting facial nerve outcome. The incidence rates of hemifacial spasm, metallic taste and crocodile tear syndrome were recorded. RESULTS: For tumours less than 1.5 cm, 95 per cent of outcomes were normal, 100 per cent were satisfactory (House-Brackmann grades I-III) and 0 per cent were unsatisfactory (grades IV-VI). For tumours 1.5-2.4 cm, 83 per cent of outcomes were normal, 99 per cent were satisfactory and 1 per cent were unsatisfactory. For tumours 2.5-3.4 cm, 68 per cent of outcomes were normal, 96 per cent were satisfactory and 4 per cent were unsatisfactory. For tumours 3.5-4.4 cm, 52 per cent of outcomes were normal, 80 per cent were satisfactory and 20 per cent were unsatisfactory. For tumours larger than 4.4 cm, 50 per cent of outcomes were normal, 72 per cent were satisfactory and 28 per cent were unsatisfactory. CONCLUSION: Tumour size and operation year were significant predictors of facial nerve outcome. The surgical learning curve was steepest for the first 50 patients.
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