경미로 접근법을 통한 전정신경초종 수술에서 술 후 안면신경 기능의 분석

• 영문명: Post-operative facial nerve function in vestibular schwannoma surgery via translabyrinthine approach
• 발행기관: 대한두개저학회
• 저자명: 서민영(Min Young Seo) 조양선(Yang-Sun Cho) 박가영(Ga Young Park) 홍성화(Sung Hwa Hong) 정원호(Won-Ho Chung) 박관(Kwan Park) 공두식(Doo-Sik Kong) 설호준(Ho Jun Seol)
• 간행물 정보: 『대한두개저학회지』제5권 제1호, 12~17쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2010.06.30

영문 초록

Introduction : One of the therapeutic goals for vestibular schwannoma (VS) is to preserve the function of cranial nerves, especially the facial nerve (FN). The purpose of this study was to determine the relationship between tumor origin, size and outcomes of FN function in VS surgery via translabyrinthine approach. Methods : To determine the characteristics of tumor and FN outcomes, medical records and MRI were reviewed retrospectively in a series of 39 patients who underwent gross total removal of VS via translabyrinthine approach. FN function was graded according to the House-Brackmann (H-B) grading immediately after surgery and at 1 year postoperatively. Results : The tumor originated from inferior vestibular nerve (IVN) was 38.5 % (n=15) and that of superior vestibular nerve (SVN) was 30.8% (n=12). Twelve out of 15 (80%) patients with IVN tumors and 10 (83.3%) out of 12 patients with SVN tumors achieved HB grade I-II facial nerve function at immediate and 1-year after the surgery. (p=0.825, p=0.396) In comparison between tumor size and FN function, immediate postoperative satisfactory FN outcome of HB I-III were achieved in 4 (80%), 8 (80%), 12 (70.6%) and 3 (42.9%) patients with intracanalicular tumor, tumor less than 1cm, 1.1-2.5cm and 2.6-4cm, respectively. One-year postoperatively, HB grade I-II could be observed in 4 (80%), 9 (90%), 13 (76.5%) and 4 (57.1%) patients. In overall, FN function of HB grade I-III was achieved in 71.8% immediately and 76.9% 1-year after surgery. Conclusions : The result of the facial nerve preservation did not differ significantly according to tumor location. The preservation of facial nerve function seems to be correlated with size of the tumor. More than 3/4 of VS patients could maintain their FN function of HB grade I-II after translabyrinthine approach at 1 year follow-up.

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키워드

Schwannoma Vestibular Facial Nerve Surgery Translabyrinthine