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Pre-operative and per-operative factors conditioning long-term facial nerve function in vestibular schwannoma surgery through translabyrinthine approach

Published online by Cambridge University Press:  29 June 2007

Olivier Deguine ,
André Maillard ,
Alain Bonafe ,
Hassan El Adouli ,
Michel Tremoulet  and
Bernard Fraysse
Olivier Deguine*
Affiliation:
Department of Otolaryngology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
André Maillard
Affiliation:
Department of Neurosurgery, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Alain Bonafe
Affiliation:
Departments of Neuroradiology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Hassan El Adouli
Affiliation:
Department of Otolaryngology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Michel Tremoulet
Affiliation:
Department of Neurosurgery, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
Bernard Fraysse
Affiliation:
Department of Otolaryngology, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France
*
Address for correspondence: Olivier Deguine, ENT Department, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Place du Docteur Baylac, 31059 Toulouse Cédex, France. Fax: +33 05 61 49 36 44 e-mail: deguine@cerco.ups-tlse.fr
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Abstract

Facial nerve function was evaluated in 103 patients, after vestibular schwannoma removal through the translabyrinthine approach. The mean follow-up was 43 months (minimum six months). Grade I facial function was achieved in 100 per cent of stage I schwannomata compared with 36 per cent of stage IV schwannomata. Grade I or II facial function was found in 78 per cent of homogeneous schwannomata, compared with 48 per cent of heterogeneous schwannomata. Facial function was preserved in 89 per cent of cases, if the angle between the internal auditory canal and the schwannoma was >66°, compared with 54 per cent if the angle was <66°. There was 82 per cent of normal facial function when the nerve appeared normal after tumour removal, compared with 18 per cent when the nerve was traumatized. When the ratio (stimulation threshold at the internal auditory canal/stimulation threshold at brainstem) was <2, postoperative facial function was preserved in 87 per cent of cases, compared with 13 per cent when the ratio was >2.

Keywords

Vestibular schwannomaSurgery, operativeFacial nerve

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 5 , May 1998 , pp. 441 - 445
Copyright
Copyright © JLO (1984) Limited 1998

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