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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center.
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Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center.

机译：三级护理学术中心的359例前庭神经鞘瘤切除术的神经起源，肿瘤大小，听力保护和面神经结局。

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摘要

OBJECTIVE:: To determine nerve of origin, tumor size, hearing preservation rates, and facial nerve outcomes in a retrospective cohort study of patients undergoing translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) approaches to vestibular schwannomas (VS). STUDY DESIGN:: Retrospective. METHODS:: Chart review. RESULTS:: Patient charts from 231 TL, 70 MCF, 53 SO, and 5 combined TL/SO procedures for VS were evaluated in 356 patients. The inferior vestibular nerve (IVN) was the nerve of origin in 84 of 359 cases (23.3%), while the superior vestibular nerve (SVN) was the nerve of origin in 36 patients (10%). In 239 of 359 cases (66.6%), the nerve of origin was not identified. Forty patients undergoing hearing preservation surgery had hearing results and nerve of origin data available for review. Functional hearing (<50dB PTA and >50% speech discrimination) was preserved in 10 of 15 patients (75%) with SVN tumors, while only 7 of 25 patients (28%) with IVN tumors retained functional hearing. Facial nerve outcomes and nerve of origin were recorded simultaneously in 109 patients. Seventy-one of 74 patients (95%) patients with IVN tumors achieved a House-Brackmann (HB) grade I-III, while 35 of 35 patients (100%) with SVN tumors retained HB I-III facial function. Looking at tumor size versus hearing preservation, functional hearing was preserved in 22 of 49 patients (45%) with <1-cm tumors, and 4 of 20 patients (20%) with 1- to 1.5-cm tumors. For all cases with documented facial nerve function, HB I-III were achieved in 96% of SO, 94% of MCF, and 88% of TL procedures. CONCLUSIONS:: Our retrospective data indicated that IVN tumors were twice as common as SVN tumors. The nerve of origin did not affect facial nerve outcomes but did impact hearing preservation rates. Patients with tumors <1 cm in size had the best chance for hearing preservation. Overall facial nerve preservation was excellent with >90% achieving HB 1 to 3 function at final follow-up.
机译：目的：在一项回顾性队列研究中，对接受经迷路迷路（TL），中颅窝（MCF）和后乙状窦/枕下（SO）入路的患者进​​行回顾性队列研究，以确定起源神经，肿瘤大小，听力保护率和面神经结局schwannomas（VS）。研究设计：：回顾性研究。方法：图表审查。结果：在356例患者中评估了231例TL，70例MCF，53例SO和5种TL / SO合并VS的患者图表。前庭神经（IVN）是359例中的84例（23.3％）的起源神经，而前庭神经（SVN）是36例（10％）的起源神经。在359例病例中有239例（66.6％）未发现起源神经。接受听力保留手术的40例患者的听力结果和神经来源数据可供审查。在15例SVN肿瘤患者中，有10例（75％）保留了功能性听力（<50dB PTA和> 50％语音辨别力），而在25例IVN肿瘤患者中，只有7例保留了功能性听力。 109例患者同时记录了面神经预后和起源神经。 74例IVN肿瘤患者中有71例（95％）达到了House-Brackmann（HB）I-III级，而SVN肿瘤35例患者中有35例（100％）保留了HB I-III面部功能。从肿瘤大小与听力保护的关系来看，49例<1-cm肿瘤患者中有22例（45％）保留了功能性听力，20例1-cm至1.5cm肿瘤患者中有4例（20％）保留了功能性听力。对于所有具有面神经功能的病例，在96％的SO，94％的MCF和88％的TL手术中均达到HB I-III。结论：我们的回顾性数据表明，IVN肿瘤是SVN肿瘤的两倍。起源神经不会影响面神经结局，但会影响听力保存率。肿瘤<1 cm的患者有最大的机会保留听力。总体面部神经保护效果极佳，在最终随访中> 90％达到HB 1至3功能。

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