Acta otorrinolaringologica espanola · 2026
Facial nerve outcomes following vestibular schwannoma surgery: Multivariate analysis of possible prognostic factors.
СтатьяНазвание и аннотация: Перевод в очереди
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El-Kholy Noha Ahmed, Lassaletta Luis, Moneir Waleed, Abdeltawwab Mohamed Moustafa, Kassem Mohamed, Ghonim Mohamed Rashad, Morales-Puebla José Manuel, Gavilán Javier
Аннотация
OBJECTIVE: Preservation of facial nerve (FN) function is one of the most important goals addressed during surgery of vestibular schwannoma (VS). The main target of the present study is to assess all possible influencing factors on FN outcomes and detect independent predictors via a multivariate analysis.
METHODS: This study included 77 patients, retrospectively reviewed, who underwent excision of unilateral VS via a translabyrinthine approach in a tertiary referral center. All clinical, radiological and intraoperative factors were evaluated regarding their effect on FN. All included cases had normal facial function preoperatively. Prognostic factors for FN outcome were assessed at two time points: at the time of discharge, 8th day postoperatively, and at one year to detect early and established results, respectively.
RESULTS: At the one-year follow-up evaluation, good/accepted FN function (House-Brackmann I-III) was observed in 66 of 77 patients (85.71%) and fair/poor function (House-Brackmann IV-VI) in 11 of 77 (14.3%). Size of the tumor, relation to the internal auditory canal (IAC), nerve stimulation at the end of surgery were found as independent prognostic factors for facial nerve outcomes. The cutoff point of the extra-canalicular diameter of the tumor beyond which the risk of FN injury increases was found to be 26.5mm.
CONCLUSION: At the end of the follow-up period, the most important predictive factor for good/accepted FN outcomes after a TL approach for VS in our series have been identified as follows, small tumor size, positive nerve stimulation at the end of the surgery and centralized position on internal auditory canal.
METHODS: This study included 77 patients, retrospectively reviewed, who underwent excision of unilateral VS via a translabyrinthine approach in a tertiary referral center. All clinical, radiological and intraoperative factors were evaluated regarding their effect on FN. All included cases had normal facial function preoperatively. Prognostic factors for FN outcome were assessed at two time points: at the time of discharge, 8th day postoperatively, and at one year to detect early and established results, respectively.
RESULTS: At the one-year follow-up evaluation, good/accepted FN function (House-Brackmann I-III) was observed in 66 of 77 patients (85.71%) and fair/poor function (House-Brackmann IV-VI) in 11 of 77 (14.3%). Size of the tumor, relation to the internal auditory canal (IAC), nerve stimulation at the end of surgery were found as independent prognostic factors for facial nerve outcomes. The cutoff point of the extra-canalicular diameter of the tumor beyond which the risk of FN injury increases was found to be 26.5mm.
CONCLUSION: At the end of the follow-up period, the most important predictive factor for good/accepted FN outcomes after a TL approach for VS in our series have been identified as follows, small tumor size, positive nerve stimulation at the end of the surgery and centralized position on internal auditory canal.