gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Prospective and randomized study for the benefit of cochlear and facial nerve function from prophylactic vasoactive treatment following acoustic neuroma surgery

Prospektive und randomisierte Studie zur Verbesserung der Funktion des Hör- und Gesichtsnerven durch die prophylaktische Gabe vasoaktiver Medikamente nach der Resektion von Akustikusneurinomen

Meeting Abstract

  • corresponding author C. Scheller - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg
  • H.-P. Richter - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg
  • M. Engelhardt - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg
  • G. Antoniadis - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.07.09

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc208.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Scheller et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Depending on the size of the tumour, facial nerve paresis and loss of hearing are common complications after acoustic neuroma surgery. Experiments with facial nerves of the rat and retrospectively analysed clinical studies showed a beneficial effect of vasoactive treatment on the preservation of the facial and the cochlear nerve function. Results of a prospective and randomized study on prophylactic vasoactive treatment in acoustic neuroma surgery have never been published before.

Methods: Patients were divided into two groups before surgery in a randomized procedure. One of the groups received a vasoactive prophylaxis consisting of nimodipine and hydroxyethylstarch which started the day before surgery and was continued until the seventh postoperative day. The other group was not given preoperative medication. Intraoperative monitoring including acoustic evoked potentials and free-running EMG was applied to all patients. However, when electrophysiological signs of a deterioration of facial or cochlear nerve function were detected in the group of patients without medication, vasoactive treatment was started intraoperatively. The function of the cochlear and facial nerve was documented preoperatively, postoperatively during the first seven days and again after long-term observation.

Results: In the group of patients, who had received prophylactic vasoactive treatment, hearing was preserved in 64% (7 of 11 cases) whereas in the other group this positive result could only be achieved in 29% (4 of 14 cases). In addition to that the treated group showed better results with respect to the improvement of facial nerve function in the long-term comparison. In this context it is important to mention that tumour sizes were comparable in both groups. Measurement of the average tumour size showed 2.0 cm in the treated group and 2.2 cm in the other group. Serious side effects of the vasoactive treatment were not observed.

Conclusions: Despite the few numbers of cases and the fact of this study being still in process these first results indicate that prophylactic vasoactive treatment leads to a functional improvement of facial and cochlear nerves after acoustic neuroma surgery. For the future one could think of vasoactive medication used in a routine and prophylactic way.