Laryngoscope investigative otolaryngology · 2024
Current approaches to facial nerve schwannoma surgery.
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Hernandez-Montero Elena, Garcia-Ibañez Luis, Jubes Sara, Salmeron Jorge, Garcia-Ibañez Emilio, Larrosa Francisco
Аннотация
BACKGROUND: Facial nerve schwannomas (FNSs) are exceedingly rare benign tumors. This study aims to report on a series of excised FNSs, providing clinical information and details on their surgical management, including novel approaches.
METHODS: We retrospectively reviewed patients who underwent surgical excision of FNSs in a private otology clinic and public tertiary referral center. The main outcome measures were facial nerve function, complete tumor removal, postoperative complications, tumor recurrence, and hearing.
RESULTS: Seventeen patients (10 men and 7 women) with a mean age of 44.23 years (SD, 12.21) underwent surgery during the study period. The most common symptom was facial nerve dysfunction (58.8%). Facial and otoneurologic symptoms (hearing loss, tinnitus, and vertigo) were observed in 88.8% and 77.7% of patients, respectively. The middle cranial fossa (MCF) was the most common approach (six patients, 35.2%), followed by translabyrinthine (TL), transmastoid (TM), and combined TM-MCF (three patients, 17.6% each). Exclusive endoscopic transcanal suprageniculate (ETS) and mastoid combined with cervical approaches were applied once in two patients, 5.8% each. Total tumor removal was achieved in all cases. No significant postoperative complications were observed. The mean follow-up period was 193.2 months (SD, 119.5) and no tumor recurrence was observed.
CONCLUSION: This study provides further evidence for the safety and efficacy of various surgical approaches for FNS, and incorporates the endoscopic transcanal approach.
LEVEL OF EVIDENCE: 4.
METHODS: We retrospectively reviewed patients who underwent surgical excision of FNSs in a private otology clinic and public tertiary referral center. The main outcome measures were facial nerve function, complete tumor removal, postoperative complications, tumor recurrence, and hearing.
RESULTS: Seventeen patients (10 men and 7 women) with a mean age of 44.23 years (SD, 12.21) underwent surgery during the study period. The most common symptom was facial nerve dysfunction (58.8%). Facial and otoneurologic symptoms (hearing loss, tinnitus, and vertigo) were observed in 88.8% and 77.7% of patients, respectively. The middle cranial fossa (MCF) was the most common approach (six patients, 35.2%), followed by translabyrinthine (TL), transmastoid (TM), and combined TM-MCF (three patients, 17.6% each). Exclusive endoscopic transcanal suprageniculate (ETS) and mastoid combined with cervical approaches were applied once in two patients, 5.8% each. Total tumor removal was achieved in all cases. No significant postoperative complications were observed. The mean follow-up period was 193.2 months (SD, 119.5) and no tumor recurrence was observed.
CONCLUSION: This study provides further evidence for the safety and efficacy of various surgical approaches for FNS, and incorporates the endoscopic transcanal approach.
LEVEL OF EVIDENCE: 4.