ABSTRACT
The major objectives in vestibular schwannoma (VS) surgery have evolved from reducing
mortality to functional preservation of the facial nerve and hearing. Absence of fluid
between the lateral end of the VS and the internal auditory canal fundus on magnetic
resonance imaging (MRI) appeared to have a negative influence on hearing outcome.
Our goal was to study the prognostic significance of fundus obliteration on facial
nerve function after VS surgery in patients with clinically normal facial function.
We performed a retrospective review in a tertiary referral neurotology unit or 110
consecutive patients with a surgically removed VS and normal preoperative facial nerve
function. Facial nerve function was evaluated at 1 month and 1 year by using the House-Brackmann
(HB) scale and correlated to fundus obliteration on MRI. Facial nerve function was
intact preoperatively in 114 of 123 patients (92.7%). We noticed a statistically significant
difference and worse short-term outcome when the fundus was obliterated: 29.7% had
HB 3 or more versus 13.0% if no fundus obliteration was seen. This statistically significant
difference disappeared at 1 year. Fundus obliteration has a negative prognostic influence
on short-term facial nerve function after VS surgery in patients with clinically normal
facial function preoperatively.
KEYWORDS
Vestibular schwannoma - acoustic neuroma - magnetic resonance imaging - facial paralysis
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Thomas SomersM.D. Ph.D.
Skull Base Team, St. Augustinus Hospital
Oosterveldlaan 24, 2610 Wilrijk, Antwerp, Belgium
eMail: thomas.somers@gza.be