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首页> 外文期刊>Otology and neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology >A model for early prediction of facial nerve recovery after vestibular schwannoma surgery.
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A model for early prediction of facial nerve recovery after vestibular schwannoma surgery.

机译：前庭切氏瘤手术后早期预测面神经恢复的模型。

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OBJECTIVE: : To identify early predictors of long-term facial nerve function after vestibular schwannoma resection. STUDY DESIGN: : Retrospective chart review. SETTING: : Tertiary referral center. PATIENTS: : Subjects with facial nerve weakness despite anatomic preservation of the nerve after removal of vestibular schwannoma. INTERVENTION: : Surgical resection of vestibular schwannoma. MAIN OUTCOME MEASURE: : Facial function after 1 postoperative year. Independent variables included patient demographics, presenting symptoms, tumor size and location, and serial postoperative function within the first year. RESULTS: : Among 281 patients with postoperative facial weakness, 81% improved to a House-Brackmann (HB) III or better (good outcome) after 12 months of recovery, whereas 12% remained HB IV or worse (poor outcome). For patients starting with HB V or VI function, recovery rate was the most reliable predictor of poor outcome after 1 year. The resulting predictive model using rate of functional improvement as the independent variable was found to anticipate poor outcome before 1 year in more than 50% of cases with 97% sensitivity and 97% specificity. Although associated with facial nerve outcome, tumor size, tumor vascularity, preoperative facial function, age at surgery, and ability to stimulate the nerve intraoperatively did not contribute significantly to the predictive model. CONCLUSION: : The rate of recovery within the first postoperative year serves as a useful early predictor of long-term facial nerve function. We present a novel predictive model using rate of recovery that can be used to select candidates for reanimation surgery sooner than the traditional waiting period of 1 year, potentially improving the outcome of this intervention.
机译：目的：：确定前庭切片瘤切除后长期面部神经功能的早期预测指标。研究设计：：回顾性图表评论。设置：：三级推荐中心。患者：：除去前庭切尼瘤后神经的解剖学保存，但具有面部神经无力的受试者。干预：：前庭造型瘤的手术切除。主要结果度量：：术后1年后的面部功能。自变量包括患者人口统计，表现症状，肿瘤大小和位置以及第一年内术后功能。结果：：在281例术后面部弱点患者中，恢复12个月后，有81％的人改善了房屋Brackmann（HB）III或更好（良好的结果），而12％的HB IV或更差的HB IV或更糟（结果差）。对于从HB V或VI功能开始的患者，恢复率是1年后预后不良的最可靠预测指标。在超过50％的敏感性和97％的特异性的病例中，发现使用功能改进速率作为独立变量的预测模型预期在1年之前会糟糕。尽管与面部神经结局，肿瘤大小，肿瘤血管，术前面部功能，手术年龄以及术中神经刺激神经的能力相关，但对预测模型没有显着贡献。结论：：术后第一年的恢复率是长期面神经功能的有用早期预测指标。我们使用恢复速率提出了一种新颖的预测模型，该模型可用于选择比传统的1年等待期更快地选择候选者进行复兴手术，从而有可能改善这种干预措施的结果。

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