Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results.

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Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results. / Martin, Thomas; Fox, H; Ho, EC; Holder, Roger; Walsh, R; Irving, Richard.

In: The Journal of laryngology and otology, 13.12.2011, p. 1-5.

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@article{d2947b5b50764449afe2dc6e62354bb1,
title = "Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results.",
abstract = "Objectives:To determine the implications of a functional approach to vestibular schwannoma surgery, with facial nerve function prioritised higher than total tumour excision.Study design:A case-control study in a tertiary referral neurotology clinic.Patients:A 'functional' surgical group treated after April 2007 (n = 44, mean cerebellopontine angle dimension 27 mm), and an 'excisional' surgical group matched for tumour size, treated from 1997 to April 2007 (n = 115).Intervention:Change to more functional surgical approach.Main outcomes measured:Primary outcome: facial nerve status. Secondary outcome: tumour recurrence in less-than-total tumour excision.Results:Facial nerve preservation: 77 per cent House-Brackmann grade I-II in functional group at 12 months, versus 57 per cent grade I-II in excisional group (p = 0.027). Tumour recurrence: 1 per cent in total excision group, 2 per cent in near-total group and 40 per cent in sub-total group.Conclusion:A functional approach to vestibular schwannoma surgery improves facial nerve preservation outcomes and reduces the requirement for facial nerve rehabilitative interventions. Tumour recurrence rates are low in near-totally excised lesions but significant if only sub-total excision is achieved.",
author = "Thomas Martin and H Fox and EC Ho and Roger Holder and R Walsh and Richard Irving",
year = "2011",
month = dec,
day = "13",
doi = "10.1017/S0022215111003124",
language = "English",
pages = "1--5",
journal = "The Journal of laryngology and otology",
issn = "0022-2151",
publisher = "Cambridge University Press",

}

RIS

TY - JOUR

T1 - Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results.

AU - Martin, Thomas

AU - Fox, H

AU - Ho, EC

AU - Holder, Roger

AU - Walsh, R

AU - Irving, Richard

PY - 2011/12/13

Y1 - 2011/12/13

N2 - Objectives:To determine the implications of a functional approach to vestibular schwannoma surgery, with facial nerve function prioritised higher than total tumour excision.Study design:A case-control study in a tertiary referral neurotology clinic.Patients:A 'functional' surgical group treated after April 2007 (n = 44, mean cerebellopontine angle dimension 27 mm), and an 'excisional' surgical group matched for tumour size, treated from 1997 to April 2007 (n = 115).Intervention:Change to more functional surgical approach.Main outcomes measured:Primary outcome: facial nerve status. Secondary outcome: tumour recurrence in less-than-total tumour excision.Results:Facial nerve preservation: 77 per cent House-Brackmann grade I-II in functional group at 12 months, versus 57 per cent grade I-II in excisional group (p = 0.027). Tumour recurrence: 1 per cent in total excision group, 2 per cent in near-total group and 40 per cent in sub-total group.Conclusion:A functional approach to vestibular schwannoma surgery improves facial nerve preservation outcomes and reduces the requirement for facial nerve rehabilitative interventions. Tumour recurrence rates are low in near-totally excised lesions but significant if only sub-total excision is achieved.

AB - Objectives:To determine the implications of a functional approach to vestibular schwannoma surgery, with facial nerve function prioritised higher than total tumour excision.Study design:A case-control study in a tertiary referral neurotology clinic.Patients:A 'functional' surgical group treated after April 2007 (n = 44, mean cerebellopontine angle dimension 27 mm), and an 'excisional' surgical group matched for tumour size, treated from 1997 to April 2007 (n = 115).Intervention:Change to more functional surgical approach.Main outcomes measured:Primary outcome: facial nerve status. Secondary outcome: tumour recurrence in less-than-total tumour excision.Results:Facial nerve preservation: 77 per cent House-Brackmann grade I-II in functional group at 12 months, versus 57 per cent grade I-II in excisional group (p = 0.027). Tumour recurrence: 1 per cent in total excision group, 2 per cent in near-total group and 40 per cent in sub-total group.Conclusion:A functional approach to vestibular schwannoma surgery improves facial nerve preservation outcomes and reduces the requirement for facial nerve rehabilitative interventions. Tumour recurrence rates are low in near-totally excised lesions but significant if only sub-total excision is achieved.

U2 - 10.1017/S0022215111003124

DO - 10.1017/S0022215111003124

M3 - Article

C2 - 22152700

SP - 1

EP - 5

JO - The Journal of laryngology and otology

JF - The Journal of laryngology and otology

SN - 0022-2151

ER -