Clinical and Histologic Parameters Correlated with Facial Nerve Function After Vestibular Schwannoma Surgery

Abstract

This study was conducted to identify clinical and histologic factors that would influence, independently of tumor staging, postoperative facial function after removal of a vestibular schwannoma. A prospective study was performed on 35 consecutive patients with vestibular schwannomas who underwent the translabyrinthine approach. Facial function was assessed before and 1 year after surgery. The factors that influenced the postoperative outcome of the facial function independently of tumor staging were the absence or the desynchronization of homolateral auditory brainstem responses and tumor edema. Other factors (audiovestibular signs of brainstem compression, tumor inflammation, positive p53 protein immunostaining) were predictive of postoperative facial function but also correlated with tumor staging. Besides the well-known prognostic value of tumor staging for postoperative facial outcome, clinical (auditory brainstem responses) and histologic (tumor edema) factors correlated with postoperative facial function.

The impact of the MIB-1 index on facial nerve outcomes in vestibular schwannoma surgery

“…Often, further surgical interventions, such as hypoglossal-facial nerve anastomosis [21] or treatment of eye irritations and tear dysfunctions, are necessary to maintain quality of life [2]. In addition to the influence of surgical and technical advances on the postoperative maintenance of facial nerve function, tumour oedema, the Antoni B/A ratio, and proliferation are also viewed as prognostic factors [14]. Furthermore, an immune response and tumour-associated macrophages are also commonly found in VS and are predominantly located in Antoni B areas [44], with their amount correlated with the duration of baseline symptoms [26], tumour volume [16], and the tumour growth rate [17].…”

Radiological and Clinical Factors Predicting the Facial Nerve Outcome following Retrosigmoid Approach for Large Vestibular Schwannomas (VSs)

“…[10][11][12] Moreover, the effect on facial nerve outcome of several other factors such as histological features, clinical presentation, extrameatal tumor extension, bony changes in the internal acoustic meatus, and radiological features has been documented. [11][12][13][14][15] However, the majority of these studies lacked uniformity in terms of surgical approaches, operating surgeons, techniques of tumor excision, and methods of facial nerve preservation. The aim of our study was to identify various radiological and clinical factors that correlate with the facial nerve outcome after VS surgery using the retrosigmoid approach.…”

Cyclin D1 Expression and Facial Function Outcome After Vestibular Schwannoma Surgery

“…Stimulation of the facial nerve after tumor removal, surgical approach, adherence of the tumor to the facial nerve, and displacement pattern of the facial nerve have been suggested as prognostic intraoperative factors (3). Antoni type and tumor edema have been described as postoperative prognostic factors (4). However, there is still controversy about the importance of all these factors in terms of prediction of postoperative facial function for a particular patient.…”