Issue N# 1 - 2014
OTONEUROLOGY
Facial nerve outcome after vestibular schwannoma surgery: About 89 patients
Authors : Guelfi F, Litré CF, Bazin A, Rousseaux P, Chays A. (Reims)
Ref. : Rev Laryngol Otol Rhinol. 2014;135,1:3-9.
Article published in french 
Downloadable PDF document french
Summary :
Objectives: We evaluated the postoperative facial nerve function after vestibular schwannoma (VS) surgery and analyzed factors causing it. Material and methods: We included 89 consecutive patients undergoing surgical excision of unilateral VS. Patient and tumor characteristics, surgical approaches, facial nerve function, extent of tumor resection and complications were analyzed. Results: Complete tumor resection was achieved in 85% of cases. Anatomic preservation of the facial nerve was achieved in 96% of patients. In all tumor stages, 88.2% of patients, have a normal or subnormal facial function within one year of the intervention, the rate was 100% in patients carrying a VS stage I or II. No severe complication or death was reported. Conclusion: Short- and long-term facial nerve outcome was comparable with results of other recent series reported in literature. The facial nerve function after surgery was better with small VS compared to large VS. The intraoperative decision of near-total excision of the tumor followed by adjuvant radiotherapy, in some cases, can prove to be a good option in the interest of better preservation of the facial nerve function. The adhesion of the facial nerve and its complex relationship with the tumor remain mysterious; RMI can bring significant refinements, helping to get the best preservation of facial function rate, in the coming years.
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