Prognostic Factors for Facial Nerve Outcome after Vestibular Schwannoma Surgery: A 12-Year Multicentric Retrospective Study.

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Otology & Neurotology Pub Date : 2025-06-09 DOI:10.1097/MAO.0000000000004582

Lucidi Daniela, Marchioni Daniele, Bisi Nicola, Calvaruso Federico, Presutti Livio, Alicandri-Ciufelli Matteo, Donvito Sara

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引用次数: 0

Abstract

Introduction: This study aimed to evaluate facial nerve (FN) impairment in patients undergoing three vestibular schwannoma (VS) surgical techniques and identify variables influencing FN function.

Materials and methods: A retrospective multicentric analysis was conducted on patients treated between 2010 and 2022 using retrosigmoid (RS), translabyrinthine (TL), or transcanal transpromontorial surgery (TTS). All participants had normal preoperative FN function and no previous radiotherapy. FN function was evaluated immediately, 6, 12, and 24 months post-surgery using the HB scale.

Results: Among 234 patients, the median FN grade was HB III immediately post-surgery, improving to HB II at 6, 12, and 24 months. Transient FN palsy occurred in 48%, whereas permanent palsy affected 39%. Higher Koos grades were significantly associated with worse FN outcomes. Older age correlated with poorer recovery at 6, 12, and 24 months (p = 0.03, 0.009, 0.02). In Koos II cases, TL yielded better FN function than RS at 48 hours and 12 months (p = 0.03). Among Koos III patients, FN preservation rates were significantly higher with TL versus RS at all time points (p = 0.003, 0.003, 0.001, 0.004). TTS demonstrated superior FN preservation compared with RS at 12 and 24 months (p = 0.007, 0.001). Multivariate analysis revealed younger age, lower Koos, TL, and TTS as predictors of better FN outcomes.

Discussion: Younger age, lower Koos grades, and the TL and TTS approaches are significantly linked to improved FN function after VS surgery.

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前庭神经鞘瘤手术后面神经预后的预后因素：一项12年多中心回顾性研究。

本研究旨在评估接受三种前庭神经鞘瘤（VS）手术的患者的面神经（FN）损伤，并确定影响FN功能的变量。材料和方法：对2010年至2022年间接受乙状结肠后手术（RS）、经迷路手术（TL）或经scantrans - promontor手术（TTS）治疗的患者进行回顾性多中心分析。所有参与者术前FN功能正常，既往未接受过放疗。术后立即、6个月、12个月和24个月使用HB量表评估FN功能。结果：在234例患者中，术后立即FN分级中位数为HB III，在6个月、12个月和24个月时改善为HB II。短暂性FN麻痹发生率为48%，而永久性麻痹发生率为39%。较高的Koos评分与较差的FN结果显著相关。年龄越大，6个月、12个月和24个月的恢复情况越差（p = 0.03、0.009、0.02）。在Koos II病例中，TL在48小时和12个月时的FN功能优于RS （p = 0.03）。在Koos III期患者中，TL组FN保存率在所有时间点均显著高于RS组（p = 0.003, 0.003, 0.001, 0.004）。与RS相比，TTS在12个月和24个月时表现出更好的FN保存（p = 0.007, 0.001）。多变量分析显示，年轻、较低的Koos、TL和TTS是FN预后较好的预测因素。讨论：年龄较小、Koos评分较低、TL和TTS入路与VS手术后FN功能改善显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otology & Neurotology 医学-耳鼻喉科学

CiteScore

3.80

自引率

14.30%

发文量

509

审稿时长

3-6 weeks

期刊介绍： Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.