Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation
机构：[1]Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China研究所北京市神经外科研究所首都医科大学附属天坛医院[2]Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[3]Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, China研究所北京市神经外科研究所首都医科大学附属天坛医院
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.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81372715, 8150110473, 61671187]; Beijing Natural Science Foundation of ChinaBeijing Natural Science Foundation [7162057]
第一作者机构：[1]Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China[2]Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
通讯作者：
通讯机构：[1]Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China[2]Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China[3]Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, China
推荐引用方式(GB/T 7714)：
Fu Zhao,Bo Wang,Zhijun Yang,et al.Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation[J].JOURNAL OF NEURO-ONCOLOGY.2018,138(2):417-424.doi:10.1007/s11060-018-2812-x.
APA：
Fu Zhao,Bo Wang,Zhijun Yang,Qiangyi Zhou,Peng Li...&Pinan Liu.(2018).Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation.JOURNAL OF NEURO-ONCOLOGY,138,(2)
MLA：
Fu Zhao,et al."Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation".JOURNAL OF NEURO-ONCOLOGY 138..2(2018):417-424
