gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Article

Send article

Interobserver variability of facial nerve function following vestibular schwannoma resection

Meeting Abstract

Search Medline for

  • Christian Scheller - Neurochirurgische Klinik der Universität Halle-Wittenberg
  • Thomas Kretschmer - Neurochirurgische Klinik der Universität Oldenburg
  • Veit Rohde - Neurochirurgische Klinik der Universität Göttingen
  • Kajetan von Eckardstein - Neurochirurgische Klinik der Universität Göttingen
  • Barbara Bischoff - Neurochirurgische Klinik der Universität Erlangen-Nürnberg
  • Oliver Ganslandt - Neurochirurgische Klinik der Universität Erlangen-Nürnberg
  • Maria-Teresa Pedro - Neurochirurgische Klinik der Universität Ulm
  • Gregor Antoniadis - Neurochirurgische Klinik der Universität Ulm
  • Marcos Tatagiba - Neurochirurgische Klinik der Universität Tübingen
  • Alireza Gharabaghi - Neurochirurgische Klinik der Universität Tübingen
  • Kristofer Ramina - Neurochirurgische Klinik der Universität Tübingen
  • Cordula Matthies - Neurochirurgische Klinik der Universität Würzburg
  • Thomas Westermaier - Neurochirurgische Klinik der Universität Würzburg
  • Mario Löhr - Neurochirurgische Klinik der Universität Würzburg
  • Johannes Zenk - HNO-Klinik der Universität Erlangen-Nürnberg
  • Thomas Meusel - HNO-Klinik der Universität Erlangen-Nürnberg
  • Malte Kornhuber - Neurologische Klinik der Universität Halle-Wittenberg
  • Christian Strauss - Neurochirurgische Klinik der Universität Halle-Wittenberg

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.02.02

doi: 10.3205/14dgnc272, urn:nbn:de:0183-14dgnc2729

Published: May 13, 2014

© 2014 Scheller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: The House-Brackmann (HB) scale was selected as the standard for classification of facial nerve paresis following vestibular schwannoma surgery by the Facial Nerve Disorders Committee in 1985. The interobserver variability of the HB scale is controversially discussed.

Method: 112 patients were included in a prospective, multicenter, clinical phase III trial in order to evaluate the efficacy of prophylactic nimodipine treatment in vestibular schwannoma surgery. Photographs of the main facial movements were independently evaluated by 3 facial nerve specialists (neurologist, neurosurgeon and otolaryngologist) preoperatively, in the early postoperative course and additionally after 3, 6 and 12 months.

Results: Interobserver correlation was 97% for none or mildly impaired facial nerve function (HB I and II). In cases of postoperative facial nerve paresis of HB III-VI the interobserver correlation decreased to 32%. In 44% of the cases a difference of one grade was assessed. Interobserver variability of two (21%) and three grades (3%) were predominantly observed in cases with severe facial nerve paresis.

Conclusions: Interobserver variability in the application of the HB scale increases with the degree of facial nerve paresis. The validity of scientific publications may be influenced by this scale conditioned bias. The development of an objective and computer-assisted measurement of facial nerve function seems to be needed.