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The best candidates for nerve-sparing stripping surgery for facial nerve schwannoma

 Soon H. Park  ;  Jin Kim  ;  In S. Moon  ;  Won S. Lee 
 LARYNGOSCOPE, Vol.124(11) : 2610-2615, 2014 
Journal Title
Issue Date
Adult ; Cohort Studies ; Cranial Nerve Neoplasms/pathology ; Cranial Nerve Neoplasms/surgery* ; Facial Nerve/pathology ; Facial Nerve/surgery* ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Nerve Regeneration/physiology ; Neurilemmoma/pathology ; Neurilemmoma/surgery* ; Neurosurgical Procedures/methods* ; Organ Sparing Treatments/methods* ; Patient Selection* ; Postoperative Care ; Preoperative Care/methods ; Prognosis ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Treatment Outcome
Facial nerve ; facial palsy ; schwannoma
OBJECTIVES/HYPOTHESIS: Clinical decision making for facial nerve schwannoma is particularly complicated in patients with good facial nerve function; however, an early nerve-sparing tumor resection stripping technique minimizes facial deficits associated with treatment. The present study characterized the optimal candidate for this nerve-sparing surgical strategy in patients with good facial function. STUDY DESIGN: Retrospective study. METHODS: Nerve-sparing stripping surgery was performed on 28 patients with facial nerve schwannoma. The House-Brackmann grading system was used to assess pre- and postoperative facial function. We retrospectively analyzed pre- and postoperative facial function, duration of facial palsy, tumor size, and location and number of involved segments. The data were analyzed using Fisher exact test and independent t tests. RESULTS: Of the 28 patients, 18 successfully underwent stripping surgery and 16 had a favorable outcome. Favorable postoperative facial function was associated with good preoperative facial function (House-Brackmann grade [HBG] ≤II); small, localized tumors; and tumors located in the geniculate ganglion and/or its proximal portion. CONCLUSIONS: Patients with facial nerve schwannoma who have good preoperative facial function (HBG ≤2), tumor located in the proximal portion of the geniculate ganglion, and small tumors (<2 cm) involving one or two facial nerve segments can be the best candidates for nerve-sparing stripping surgery. LEVEL OF EVIDENCE: 4 Laryngoscope, 124:2610-2615, 2014.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Moon, In Seok(문인석) ORCID logo https://orcid.org/0000-0002-3951-5074
Lee, Won Sang(이원상)
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