Subscribe to RSS
DOI: 10.1055/s-0034-1384146
Effect of Corticosteroids on Facial Function after Cerebellopontine Angle Tumor Removal: A Double-Blind Study versus Placebo
Objective: The aim of this study was to assess the effect of corticosteroids administered intra- and postoperatively on the occurrence of facial palsy after a cerebellopontine angle (CPA) tumor resection, and to investigate pre- and intraoperative prognostic factors. Study Design: This multicenter, prospective, randomized, double-blind and versus placebo study was conducted between 2006 and 2010. Patients and Methods: Overall 310 patients operated on for a CPA tumor (96% vestibular schwannomas, 4% miscellaneous) were included by five participating centers. Population was stratified into small (<15 mm in CPA on axial MRI views) and large tumors. In each group, patients were randomized intocorticosteroid (1 mg/kg/d IV methylprednisolone intraoperatively, and from postoperative days 1-5) or placebo. The principal judgment criterion was the proportion of patients with a facial function >grade 2 (House-Brackmann) at postoperative day 8. Patients were followed up 30 days after surgery. Results: Steroids did not affect the facial function at postoperative day 8 after intention-to-treat analysis in small lesions (82% of grades 1-2, n = 104 in steroid vs.81%, n = 94 in placebo, not significant, chi-square test) and in large tumors (51% of grades 1-2, n = 56 in steroid vs.46%, n = 56 in placebo not significant, chi-square test). Facial function at postoperative days 1 and 30 and per protocol analysis did not show an effect. Postoperative complications were also similar in the groups. Conclusion: Administration of corticosteroids during and after CPA tumor surgery does not affect facial function as assessed by the House-Brackmann grading system.