Intraoperative monitoring and facial nerve outcomes after vestibular schwannoma resection. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. [Otol Neurotol] Journal article | | Title | Intraoperative monitoring and facial nerve outcomes after vestibular schwannoma resection. | | Author(s) | Isaacson B, Kileny PR, El-Kashlan H, Gadre AK | | Institution | Department of Otolaryngology-Head and Neck Surgery, University of Michigan Hospitals, Ann Arbor, MI 48109, USA. | | Source | Otol Neurotol 2003 Sep; 24(5):812-7. | | MeSH | Action Potentials
Adolescent
Adult
Aged
Electromyography
Facial Muscles
Facial Nerve
Facial Nerve Injuries
Facial Paralysis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Models, Theoretical
Monitoring, Intraoperative
Neural Conduction
Neuroma, Acoustic
Postoperative Complications
Predictive Value of Tests
Prognosis
Retrospective Studies
| | Abstract | OBJECTIVE: To determine the predictive value of proximal facial nerve electrical threshold and proximal-to-distal facial muscle compound action potential amplitude ratio on facial nerve outcomes after resection of vestibular schwannomas.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary care hospital.
PATIENTS: Two hundred twenty-nine patients undergoing resection of vestibular schwannomas with intraoperative facial nerve monitoring at a single institution.
INTERVENTION: All patients underwent resection of vestibular schwannomas with the use of intraoperative monitoring.
MAIN OUTCOME MEASURE: Facial nerve function was classified according to the House-Brackmann scale at the patient's last office follow-up. Last follow-up was at least 6 months after surgery.
RESULTS: Good facial nerve function (House-Brackmann Grade I or II) was observed in 87% of the patients at their last office follow-up. Proximal-to-distal amplitude ratio and proximal electric threshold were statistically significant in predicting facial nerve outcome. A mathematical model predicting the probability of good outcome on the basis of the intraoperative parameters is presented.
CONCLUSION: Intraoperative monitoring has significantly decreased facial nerve morbidity in vestibular schwannoma surgery. Despite the advances in surgery and monitoring, a group of patients still have poor facial nerve outcomes. The use of intraoperative nerve monitoring may be able to predict poor long-term facial nerve outcomes and thus modify the timing of rehabilitation. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 14501461 |
|
|
| |
Advertise on this site.
| | |
|
