Title:
Prognostic significance of electrophysiological tests for facial nerve outcome in vestibular schwannoma surgery
Authors:
J. J. S. van Dinther, V. Van Rompaey, T. Somers, A. Zarowski and F. E. Offeciers
Institutions:
University Department of Otorhinolaryngology and Head & Neck Surgery,Antwerp Skull Base Centre, SintAugustinus Hospital, Wilrijk, Antwerp
Keywords:
Vestibular schwannoma; microsurgery; facial nerve; electromyography
Pages:
115 - 119
Abstract:
Prognostic significance of electrophysiological tests for facial nerve outcome in vestibular schwannoma surgery. Objective: To assess the prognostic significance of pre-operative electrophysiological tests for facial nerve out- come in vestibular schwannoma surgery. Methodology: Retrospective study design in a tertiary referral neurology unit. We studied a total of 123 patients with unilateral vestibular schwannoma who underwent microsurgical removal of the lesion. Nine patients were excluded because they had clinically abnormal pre-operative facial function. Pre-operative electrophysiological facial nerve function testing (EPhT) was performed. Short-term (1 month) and long-term (1 year) post-operative clinical facial nerve function were assessed. Results: When pre-operative facial nerve function, evaluated by EPhT, was normal, the outcome from clinical follow-up at 1-month post-operatively was excellent in 78% (i.e. HB I-II) of patients, moderate in 11% (i.e. HB III-IV), and bad in 11% (i.e. HB V-VI). After 1 year, 86% had excellent outcomes, 13% had moderate outcomes, and 1% had bad out- comes. Of all patients with normal clinical facial nerve function, 22% had an abnormal EPhT result and 78% had a nor- mal result. No statistically significant differences could be observed in short-term and long-term post-operative facial function between the groups. Conclusion: In this study, electrophysiological tests were not able to predict facial nerve outcome after vestibular schwannoma surgery. Tumour size remains the best pre-operative prognostic indicator of facial nerve function outcome, i.e. a better outcome in smaller lesions.
Issue:
Vol. 7, 2011, 2nd trimester


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Prognostic significance of electrophysiological tests for facial nerve outcome in vestibular schwannoma surgery