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CC BY-NC-ND 4.0 · Asian J Neurosurg 2016; 11(04): 402-406
DOI: 10.4103/1793-5482.144208
ORIGINAL ARTICLE

Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

Graziano Taddei
1   Department of Neurosurgery, S. Salvatore Hospital, L'Aquila
,
Alfonso Marrelli
2   Department of Neurophysiopathology, S. Salvatore Hospital, L'Aquila
,
Donatella Trovarelli
3   Department of Anesthesiology, S. Salvatore Hospital, L'Aquila
,
Alessandro Ricci
1   Department of Neurosurgery, S. Salvatore Hospital, L'Aquila
,
Renato Galzio
1   Department of Neurosurgery, S. Salvatore Hospital, L'Aquila
4   University of L'Aquila, L'Aquila
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Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas.

Key-words:

Bipolar stimulator - electromyographic facial nerve monitoring - facial nerve - retrosigmoid approach - vestibular schwannomas


Publication History

Article published online:
20 September 2022

© 2016. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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