Preservation of neurological functions during the extended middle fossa approach operation of small cerebellopontine angle tumors
Journal Title: Polski Przegląd Otorynolaryngologiczny - Year 2015, Vol 4, Issue 1
Abstract
[b]Objective:[/b] The aim of our study was analysis of the factors connected with postoperative preservation of facial nerve and hearing function. [b]Material and Methods: [/b]A retrospective review of 59 patients, operated using EMFA in 1998-2008. The patients were examined in accordance with the uniform study protocol (the ENT examination, pre- and postoperative audiological examination). For the facial nerve evaluation, House-Brackmann Scale was used, while for the audiological examination AAO-HNS Classification. [b]Results:[/b] Among T1 and T2 stage patients, hearing preservation was achieved in 67.4% and 37.5%, respectively (p=0.12). There was a statistically significant correlation between better audiological results and the easily identifiable plane of dissection (relationship to the arachnoid). No statistically significant influence of intraoperative hearing monitoring was correlated with better postoperative results (53% versus 50%, p=0.86). Monitoring was used by 43.3% of patients.Preservation of the facial nerve function was observed in 81.4% of patients with T1 tumors and 66.7% of T2 tumors (p=0.20). There was no significant correlation between better treatment results and easily identifiable plane of dissection (75% versus 70.8%, p=0.72), use of intraoperative monitoring (76.7% versus 64.7%, p=0.55) and the patients’ age (100% for patients aged under 30 versus 72% for patients aged 31-50 and 67.8% for patients aged over 50, p=0.22). Monitoring was used by 71.6% of patients.[b]Conclusions: [/b]Tumor morphology has a statistically significant influence on hearing preservation but not on the facial nerve function preservation. Other factors, such as intraoperative monitoring, low tumor stage, age and location of tumor have no statistically significant influence on preservation of the neurological function.
Authors and Affiliations
Barbara Jamróz, Andrzej Marchel, Kazimierz Niemczyk, Krzysztof Morawski, Antoni Bruzgielewicz, Robert Bartoszewicz
Keywords
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