Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation

被引:0
作者
Fu Zhao
Bo Wang
Zhijun Yang
Qiangyi Zhou
Peng Li
Xingchao Wang
Jing Zhang
Junting Zhang
Pinan Liu
机构
[1] Capital Medical University,Neural Reconstruction Department, Beijing Neurosurgical Institute
[2] Capital Medical University,Department of Neurosurgery, Beijing Tian Tan Hospital
[3] Capital Medical University,Beijing Neurosurgical Institute, Beijing Tian Tan Hospital
来源
Journal of Neuro-Oncology | 2018年 / 138卷
关键词
Neurofibromatosis type 2; Vestibular schwannoma; Hearing preservation; Facial nerve; Microsurgery;
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学科分类号
摘要
Surgical treatment of vestibular schwannoma (VS) in patients with neurofibromatosis type 2 (NF2) along with functional preservation of cranial nerves is challenging. The aim of this study was to analyze the outcomes of hearing and facial nerve function in patients with NF2 who underwent large-size VS (> 2 cm) surgery. From 2006 to 2016, one hundred and forty NF2 patients were included with 149 large-size VS resections using retrosigmoid approach. Hearing function was classified according to the American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) criteria. Preoperative and one-year postoperative facial nerve function were both assessed using the House–Brackmann (H–B) grading scale. A multivariate logistic regression was performed to identify preoperative predictors for facial function outcomes. No operative death we noted. Total tumor removal was achieved in 82.6% of the operated VSs. The anatomical integrity of the facial nerve was preserved in 67.8% of surgeries. Good facial nerve function (H–B Grades I–III) was maintained in 49.6% of patients at 12 months after surgery. Tumor size larger than 3 cm and preoperative facial weakness related with worse outcome of facial nerve function (P < 0.001; for both). Hearing preservation surgeries were attempted in 31 ears. Class B or C hearing according to the AAO–HNS criteria was maintained in 7 ears (22.5%), and measurable hearing was maintained 11 ears (35.5%). It is challenging to maintain hearing and facial nerve function in NF2 patients with large VSs. Early surgical intervention is an appropriate choice to decrease the risk of neurological functions deficit.
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页码:417 / 424
页数:7
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共 104 条
[1]  
Asthagiri AR(2009)Neurofibromatosis type 2 Lancet 373 1974-1986
[2]  
Parry DM(2011)Empirical development of improved diagnostic criteria for neurofibromatosis 2 Genet Med 13 576-581
[3]  
Butman JA(2004)Genotype-phenotype correlations for nervous system tumors in neurofibromatosis 2: a population-based study Am J Hum Genet 75 231-239
[4]  
Baser ME(2002)Predictors of vestibular schwannoma growth in patients with neurofibromatosis type 2 J Neurosurg 96 217-222
[5]  
Friedman JM(2016)Therapeutic advances for the tumors associated with neurofibromatosis type 1, type 2, and schwannomatosis Neuro Oncol 18 624-638
[6]  
Joe H(2001)Early proactive management of vestibular schwannomas in neurofibromatosis type 2 Neurosurgery 49 274-280
[7]  
Baser ME(2015)Evidence of polyclonality in neurofibromatosis type 2-associated multilobulated vestibular schwannomas Neuro Oncol 17 566-573
[8]  
Kuramoto L(2012)Long-term natural history of neurofibromatosis type 2-associated intracranial tumors J Neurosurg 117 109-117
[9]  
Joe H(2005)Management of the patient and family with neurofibromatosis 2: a consensus conference statement Br J Neurosurg 19 5-12
[10]  
Baser ME(2010)Birth incidence and prevalence of tumor-prone syndromes: estimates from a UK family genetic register service Am J Med Genet A 152A 327-332