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BIBTEX RIS

Analysis of Hearing Preservation and Facial Nerve Function for Patients Undergoing Vestibular Schwannoma Surgery: The Middle Cranial Fossa Approach versus the Retrosigmoid Approach – Personal Experience and Literature Review

2011; Karger Publishers; Volume: 17; Issue: 2 Linguagem: Inglês

10.1159/000329362

ISSN

1421-9700

Autores

Marcos Rabelo de Freitas, Alessandra Russo, Giulio Sequino, Enrico Piccirillo, Mario Sanna,

Tópico(s)

Neurofibromatosis and Schwannoma Cases

Resumo

<i>Objective:</i> To compare hearing preservation and facial nerve function outcomes in patients undergoing vestibular schwannoma surgery performed using either the middle cranial fossa approach (MCFA) or the retrosigmoid approach (RSA). <i>Materials and Methods:</i> A review of the medical records of patients diagnosed with vestibular schwannoma who underwent surgical tumor removal in a single reference center via the MCFA or the RSA between January 1988 and December 2008 was conducted. <i>Results:</i> During this period, 90 patients underwent surgery via the MCFA while 86 patients received surgical treatment via the RSA. Of the patients subjected to the MCFA, 80.7% were characterized by a House-Brackmann (HB) grade I or II outcome, whereas 96.5% of patients undergoing the RSA were characterized by a HB grade I or II outcome (p = 0.001). This difference appeared only for extrameatal tumors when we compared size-matched tumors (58.3% MCFA vs. 98% RSA; p = 0.0006). There was no statistically significant difference in the hearing outcomes upon consideration of hearing preservation as characterized by the modified Sanna classification system involving classes A and B (18.9% MCFA vs. 10.6% RSA; p = 0.122). <i>Conclusion:</i> No statistically significant difference in hearing preservation was identified when comparing tumors operated upon via the MCFA versus the RSA. However, our results indicate that a higher risk of facial nerve function impairment exists if the surgery is performed via the MCFA under circumstances where the tumor extends to the cerebellopontine angle.

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