Authors: Andrea Bacciu Marimar Medina Hassen Ait Mimoune Flavia D’Orazio Enrico Pasanisi Giorgio Peretti Mario Sanna
Publish Date: 2013/12/12
Volume: 272, Issue: 2, Pages: 311-319
Abstract
The aim of this study was to report the postoperative lower cranial nerves LCNs function in patients undergoing surgery for tympanojugular paraganglioma TJP and to evaluate risk factors for postoperative LCN dysfunction A retrospective case review of 122 patients having Fisch class C or D TJP surgically treated from 1988 to 2012 was performed The followup of the series ranged from 12 to 156 months mean 394 ± 326 months The infratemporal type A approach was the most common surgical procedure Gross total tumor removal was achieved in 86 of cases Seventytwo percent of the 54 patients with preoperative LCN deficit had intracranial tumor extension Intraoperatively LCNs had to be sacrificed in 63 cases 516 due to tumor infiltration Sixtysix patients 5409 developed a new deficit of one or more of the LCNs Of those patients who developed new LCN deficits 23 of them had intradural extension Postoperative followup of at least 1 year showed that the LCN most commonly affected was the CN IX 50 Logistic regression analysis showed that intracranial transdural tumor extension was correlated with the higher risk of LCN sacrifice p 005 Despite the advances in skull base surgery new postoperative LCN deficits still represent a challenge The morbidity associated with resection of the LCNs is dependent on the tumor’s size and intradural tumor extension Though no recovery of LCN deficits may be expected on longterm followup patients usually compensate well for their LCNs loss
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