A morphological features-based nomogram for predicting facial nerve function in the immediate postoperative period after vestibular schwannoma surgery

被引：0

作者：

Fujita, Yuichi ^{[1
]}

Uozumi, Yoichi ^{[1
]}

Fujimoto, Yosuke ^{[1
]}

Nagashima, Hiroaki ^{[1
]}

Kohta, Masaaki ^{[1
]}

Tanaka, Kazuhiro ^{[1
]}

Kimura, Hidehito ^{[1
]}

Fujita, Atsushi ^{[1
]}

Kohmura, Eiji ^{[1
,2
]}

Sasayama, Takashi ^{[1
]}

机构：

[1] Kobe Univ, Dept Neurosurg, Grad Sch Med, 7-5-1 Kusunoki Cho,Chuo Ku, Kobe, Hyogo 6500017, Japan

[2] Kinki Cent Hosp, Dept Neurosurg, Itami, Hyogo, Japan

来源：

JOURNAL OF NEURO-ONCOLOGY | 2025年 / 173卷 / 02期

关键词：

Vestibular Schwannoma; Facial nerve function; Koos grade; Fundal fluid cap; Morphology; Retrosigmoid approach; RESECTION; CLASSIFICATION; OUTCOMES; PALSY; TUMOR;

D O I：

10.1007/s11060-025-04984-4

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PurposeTumor morphology critically influences facial nerve (FN) outcomes following vestibular schwannoma (VS) surgery. This study aimed to develop a nomogram based on preoperative features for preoperative prediction of FN outcomes after VS surgery. MethodsA retrospective analysis included patients with sporadic VS who underwent surgical resection via the retrosigmoid approach. Tumor size was assessed using the Koos grade, the intrameatal components using the fundal fluid cap (FFC) sign, and the cerebellopontine angle cisternal components using our modified morphological subclassification. Logistic regression analysis was performed to construct a nomogram for predicting immediate postoperative FN function. ResultsA total of 265 patients with VS met the inclusion criteria. Of these patients, 62 (23.4%) had poor FN function (House-Brackmann grade >= III) immediately after surgery. Univariate logistic regression analysis identified the Koos grade (p = 0.001), FFC sign (p = 0.023), and morphological subtype (p < 0.001) as significant predictors of poor FN function immediately after surgery. In multivariate logistic regression analysis, the FFC sign (OR 2.07, p = 0.042) and morphological subtype (OR 8.21, p < 0.001) remained statistically significant independent predictors of poor FN function. A nomogram constructed based on these indicators demonstrated good discrimination in the training cohort (area under the curve [AUC] 0.80), internal validation cohort (AUC 0.79), and external validation cohort (AUC 0.97). ConclusionsA simple and reliable nomogram incorporating the Koos grade, FFC sign, and morphological subtype accurately predicts the risk of FN injury during surgery aimed at total resection of VS. This clinically straightforward tool can assist in patient counseling and development of more individualized surgical strategies to improve FN outcomes in patients with VS.

引用

页码：305 / 315

页数：11

共 45 条

[1] Nomograms in oncology: more than meets the eye [J].