gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Functional outcome after microsurgery for previously treated vestibular schwannomas

Meeting Abstract

  • A. Rizk - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • F. Ebner - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • G. Lepski - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • F. Roser - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.12.07

DOI: 10.3205/12dgnc272, URN: urn:nbn:de:0183-12dgnc2729

Veröffentlicht: 4. Juni 2012

© 2012 Rizk 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The aim of this study was to evaluate the functional outcome after microsurgery for previously treated vestibular schwannomas (VS), either through surgery or irradiation.

Methods: The authors performed a retrospective study of 21 patients presented with recurrent and /or previously irradiated VS who underwent surgical treatment between 2006 and 2011. Follow-up ranged from 4 to 29 months (mean 11.6 months). Patient records, operative videos, electrophysiological assessment, and neuroradiological findings were retrospectively analyzed. The main outcome measures were patient complaints, functional neurological status, resection grade on MRI, and surgical complications

Results: 8 patients had been submitted to irradiation only, 9 patients had been previously operated, and 4 patients had been submitted to surgery and irradiation. Complete tumor removal was achieved in 81% of patients. Overall, anatomical preservation of the facial nerve was possible in 71.4% of the cases. Analyzing separately, the facial nerve was anatomically preserved in all irradiated cases, in 66% of the operated cases, and only in 25% of the cases submitted to surgery and irradiation (p < 0.05). By the last follow-up examination, good facial nerve function (HB Grade I or II) had been achieved in 42.8% of the cases. Moreover, facial nerve function was statistically better in the irradiated group, compared to the operated one (p < 0.05) and to both treatments combined (p < 0.05) at the last follow-up. Hearing was non-serviceable in all previously operated patients; however, two out of eight irradiated patients still presented serviceable hearing. The cochlear nerve was anatomically preserved in both patients; however hearing was preserved in only one. There was no mortality in this series. One patient developed temporary swallowing problems. Three patients developed CSF leakage.

Conclusions: Previous treatment of VS significantly affects the functional outcome after surgery, especially regarding preservation of facial nerve function. Nevertheless, previous surgery represents the most important isolated factor.