Surgical management of internal auditory canal and cerebellopontine angle facial nerve schwannoma.
Surgical management of internal auditory canal and cerebellopontine angle facial nerve schwannoma.
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DOI：
10.1097/mao.0b013e31825e7e36
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发表时间：
2012-08
期刊：
影响因子：
--
通讯作者：
Gantz B
中科院分区：
文献类型：
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作者：
Mowry S;Hansen M;Gantz B
探讨内听道面神经鞘瘤（FNS）肿瘤减灭术后的长期患者结局。回顾性病例审查三级转诊中心患者在1998-2010年期间手术，术前诊断为前庭神经鞘瘤，术中识别为FNS。诊断和治疗House-Brackmann面神经评分即时和长期随访（>1年）;肿瘤复发。16例患者被确定为前庭神经鞘瘤，但术中诊断为面神经鞘瘤。11例行肿瘤切除术（肿瘤切除率67%~ 99%），2例行单纯减压术，2例行中间神经肿瘤切除术，保留第七神经运动分支，1例行面神经移植术。11例减积患者中有5例接受了MCF入路肿瘤切除术;其余患者接受了经皮肝切除术。1例减积患者失访。10例长期随访的患者中9例为H/B级I或II级面功能。1例患者肿瘤复发，需要进行翻修手术，进行全切除和面神经移植。FNS的肿瘤减积为肿瘤切除和良好的面神经功能提供了机会。连续的面神经监测对于成功的减瘤手术至关重要。通过MCF方法进行FNS减积是可行的。保证连续术后成像以监测复发。
To investigate the long-term patient outcomes following tumor debulking for internal auditory canal facial schwannoma (FNS). retrospective case review Tertiary referral center Patients operated on between 1998–2010 for a preoperative diagnosis of vestibular schwannoma with the intraoperative identification FNS instead. diagnostic and therapeutic House-Brackmann facial nerve score immediately and at long term follow up (>1 yr); recurrence of tumor. 16 patients were identified who were presumed to have vestibular schwannoma but intraoperatively were diagnosed with facial nerve schwannoma. Eleven underwent debulking surgery (67%–99% tumor removal), 2 underwent decompression only, 2 were diagnosed with nervus intermedius tumors and had total tumor removal with preservation of the motor branch of CN VII, 1 had complete tumor removal with facial nerve grafting. Five of 11 debulking patients underwent the MCF approach for tumor removal; the remainder had translabyrinthine resections. One debulking patient was lost to follow-up. Nine of 10 patients with long term follow up had H/B grade I or II facial function. One patient had recurrence of the tumor that required revision surgery with total removal and facial nerve grafting. Tumor debulking for FNS provides an opportunity for tumor removal and excellent facial nerve function. Continuous facial nerve monitoring is vital for successful debulking surgery. FNS debulking is feasible via the MCF approach. Serial postoperative imaging is warranted to monitor for recurrence.