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2008, Number 6

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Cir Cir 2008; 76 (6)

Preservación de la función facial en la resección microquirúrgica de schwannoma vestibular

Guinto-Balanzar G, Salazar-Pérez N, Diegopérez-Ramírez J, Ramírez-Reyes AG, Félix-Espinoza I, Collado-Corona MÁ

Language: Spanish
References: 35
Page: 451-460
PDF size: 149.39 Kb.


ABSTRACT

Background: Recently, there has been considerable development in surgical techniques for vestibular schwannoma, allowing total resection with minimal morbidity and mortality. Our objective was to present a series of surgically treated patients with vestibular schwannomas and analyze clinical results, mainly related to the preservation of facial nerve function.
Methods: During a 14-year-period, all patients with vestibular schwannomas operated on were retrospectively analyzed. This series was divided into two groups: group I included patients in whom tumor resection was performed using only bipolar coagulation and standard aspiration; group II included patients in whom tumor removal was done using ultrasonic aspirator and intraoperative neurophysiological monitoring.
Results: A total of 151 patients were included in the present series, 92 women and 59 men, with an average age of 44.3 years. The most common clinical manifestations were hypacusis and vestibular symptoms; 92.7% of tumors were large or giant. Surgery was done using a retrosigmoid suboccipital approach, obtaining total removal of the tumor in 92% of cases. Overall percentage of facial nerve preservation was 67.5%, but there were evident differences when considering both groups because facial preservation was 61% in group I as compared with 90% facial preservation obtained in group II. Mortality rate was 1.9%.
Conclusions: By using ultrasonic aspirator and intraoperative neurophysiological monitoring, it is possible to completely remove vestibular schwannomas with minimal morbidity and obtaining excellent results regarding preservation of facial nerve function.


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