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  • Title: The best candidates for nerve-sparing stripping surgery for facial nerve schwannoma.
    Author: Park SH, Kim J, Moon IS, Lee WS.
    Journal: Laryngoscope; 2014 Nov; 124(11):2610-5. PubMed ID: 24984859.
    Abstract:
    OBJECTIVES/HYPOTHESIS: Clinical decision making for facial nerve schwannoma is particularly complicated in patients with good facial nerve function; however, an early nerve-sparing tumor resection stripping technique minimizes facial deficits associated with treatment. The present study characterized the optimal candidate for this nerve-sparing surgical strategy in patients with good facial function. STUDY DESIGN: Retrospective study. METHODS: Nerve-sparing stripping surgery was performed on 28 patients with facial nerve schwannoma. The House-Brackmann grading system was used to assess pre- and postoperative facial function. We retrospectively analyzed pre- and postoperative facial function, duration of facial palsy, tumor size, and location and number of involved segments. The data were analyzed using Fisher exact test and independent t tests. RESULTS: Of the 28 patients, 18 successfully underwent stripping surgery and 16 had a favorable outcome. Favorable postoperative facial function was associated with good preoperative facial function (House-Brackmann grade [HBG] ≤II); small, localized tumors; and tumors located in the geniculate ganglion and/or its proximal portion. CONCLUSIONS: Patients with facial nerve schwannoma who have good preoperative facial function (HBG ≤2), tumor located in the proximal portion of the geniculate ganglion, and small tumors (<2 cm) involving one or two facial nerve segments can be the best candidates for nerve-sparing stripping surgery. LEVEL OF EVIDENCE: 4
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