Authors: C Raftopoulos B Abu Serieh T Duprez M A Docquier J M Guérit
Publish Date: 2005/05/30
Volume: 147, Issue: 7, Pages: 697-706
Abstract
Methods Sixteen consecutive cases were operated on by the same neurosurgeon according to a prospective protocol using intraoperative neuromonitoring IONM based on electromyographic and brain stem auditory evoked potential recordings Facial nerve function was evaluated on the HouseBrackmann Scale and cochlear nerve function on the GardnerRobertson Scale Someone not involved in the clinical management of our patients collected all dataResults Fifteen patients showed facial nerve FN function of HouseBrackmann grade HBG I or II at one year postoperatively and one kept the HBG IV she had preoperatively Two patients of four maintained a cochlear nerve function of GardnerRobertson grade GRG II The tumour excision rates were total 687 near total 63 subtotal 187 and partial 63 The average followup was 55 months 1–106 Three patients underwent radiotherapy later with growth stabilisation and no additional morbidityConclusion When dealing with VS greater than or equal to 30 mm microsurgery guided by IONM with a rate of total or neartotal tumour excision of about 75 can retain socially acceptable facial nerve function HBG I or II in all cases and serviceable hearing GRG I or II in two cases out of four Maintaining serviceable cranial nerve function should take precedence over total tumour excision
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