Tang Ing Ping, Freeman Simon R, Rutherford Scott A, King Andrew T, Ramsden Richard T, Lloyd Simon K W
*Department of ORL-HNS, †Department of Neurosurgery, Salford Royal Hospital, Manchester, U.K.; ‡Department of ORL-HNS, University Malaysia Sarawak, Malaysia; §School of Cancer and Enabling Services, University of Manchester; and ∥Manchester Ear Nose and Throat Clinic, Manchester, U.K.
Otol Neurotol. 2014 Aug;35(7):1266-70. doi: 10.1097/MAO.0000000000000435.
To review the postoperative surgical outcomes of cystic vestibular schwannomas (CVSs), especially facial nerve outcomes, and compare these results with those from matched solid vestibular schwannomas (SVS) resected during the same period at a tertiary referral center.
Retrospective case series.
One hundred thirty-one surgically managed patients with cystic vestibular schwannomas (CVSs) were age, sex, and tumor size matched to 131 surgically managed patients with solid vestibular schwannomas (SVSs). Demographics, tumor morphology, surgical approach, extent of resection, facial and nonfacial complications, and recurrence rates were compared between the 2 groups. Subtotal removal was defined as removal of at least 95% of the tumor.
The mean maximal tumor diameter was 2.8 cm for both groups. For CVS, gross total tumor resection (GTR) was achieved in 92 patients (70.2%), and subtotal tumor resection (STR) was achieved in 39 patients (29.8%). Postoperative facial nerve outcomes at 1-year follow-up were good (HB Grade I-III) in 116 (88.5%) of 131 CVS patients. Twenty-three patients developed nonfacial nerve-related complications (17.6%). For SVS, GTR was achieved in 102 patients (77.9%), and STR was achieved in 29 patients (22.1%). Postoperative facial nerve outcomes at 1-year follow-up were good (HB Grade I-III) in 118 (90.1%) of 131 SVS patients. Nonfacial nerve related complications occurred in 14 patients (10.7%). None of the differences in outcome between the 2 groups were statistically significant.
The difference in surgical outcomes is minimal between patients with CVS and those with SVS, not reaching statistical significance. We think, with judicious surgical management, similar outcomes can be achieved in cystic tumors and solid tumors.
回顾囊性前庭神经鞘瘤（CVS）的术后手术结果，尤其是面神经结果，并将这些结果与同一时期在三级转诊中心切除的匹配实性前庭神经鞘瘤（SVS）的结果进行比较。
回顾性病例系列研究。
131例接受手术治疗的囊性前庭神经鞘瘤（CVS）患者在年龄、性别和肿瘤大小方面与131例接受手术治疗的实性前庭神经鞘瘤（SVS）患者相匹配。比较两组患者的人口统计学资料、肿瘤形态、手术入路、切除范围、面神经和非面神经并发症以及复发率。次全切除定义为切除至少95%的肿瘤。
两组患者的平均最大肿瘤直径均为2.8 cm。对于CVS，92例患者（70.2%）实现了肿瘤全切除（GTR），39例患者（29.8%）实现了次全切除（STR）。131例CVS患者中，116例（88.5%）在1年随访时面神经功能良好（House-Brackmann分级I-III级）。23例患者出现非面神经相关并发症（17.6%）。对于SVS，102例患者（77.9%）实现了GTR，29例患者（22.1%）实现了STR。131例SVS患者中，118例（90.1%）在1年随访时面神经功能良好（HB分级I-III级）。14例患者出现非面神经相关并发症（10.7%）。两组间的结果差异均无统计学意义。
CVS患者和SVS患者的手术结果差异极小，未达到统计学意义。我们认为，通过明智的手术管理，囊性肿瘤和实性肿瘤可以取得相似的结果。
