Mahboubi Hossein, Maducdoc Marlon M, Yau Amy Y, Ziai Kasra, Ghavami Yaser, Badran Karam W, Al-Thobaiti Majid, Brandon Bryan, Djalilian Hamid R
Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA.
Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA Department of Biomedical Engineering, University of California, Irvine, Orange, California, USA
Otolaryngol Head Neck Surg. 2015 Nov;153(5):822-31. doi: 10.1177/0194599815573223. Epub 2015 Mar 19.
To understand the differences in characteristics of neurofibromatosis type 2 (NF2) and sporadic patients with surgically excised vestibular schwannomas in the state of California.
Cross-sectional.
SETTING, SUBJECTS, AND METHODS: The records of all patients who underwent vestibular schwannoma excision between 1997 and 2011 were extracted from the California Hospital Inpatient Discharge Databases (CHIDD). NF2 cases were identified using ICD-9-CM diagnosis code 237.72, neurofibromatosis, type 2. All other cases were recoded as sporadic. Trends in total number and population-adjusted rates (per 1 million California residents) of surgery, demographics, hospital case volume, state of residency, complications, length of stay, total charges, expected source of payment, and disposition were examined.
Vestibular schwannoma (VS) excision was performed on 7017 patients, of which 464 patients (6.6%) had NF2. The population-adjusted surgery rate declined from 11.8 to 6.2 (P < .001) for sporadic cases and from 0.3 to 0.2 (P = .01) for NF2 cases over the study period. NF2 was associated with younger age (mean, 32.9 vs 51.3), higher rate of other complications (8.8% vs 4.4%) and facial nerve complications (32.3% vs 16.8%), higher total charges (median $70,106 vs $46,395), longer stay (median 5 vs 4), and high volume hospitals (80.4% vs 48.8%) (all P < .001).
The surgery rates for vestibular schwannoma excision for both sporadic and NF2 patients have declined, but the decline is more prominent for sporadic cases. NF2 patients tend to be younger and have a longer hospitalization and possibly higher corresponding hospital charges compared to patients with sporadic VS.
了解加利福尼亚州神经纤维瘤病2型（NF2）患者与接受手术切除前庭神经鞘瘤的散发性患者在特征上的差异。
横断面研究。
设置、研究对象与方法：从加利福尼亚州医院住院出院数据库（CHIDD）中提取1997年至2011年间所有接受前庭神经鞘瘤切除术患者的记录。使用ICD-9-CM诊断代码237.72（神经纤维瘤病，2型）识别NF2病例。所有其他病例重新编码为散发性病例。检查了手术总数和人群调整率（每100万加利福尼亚居民）、人口统计学特征、医院病例数量、居住州、并发症、住院时间、总费用、预期支付来源和处置情况的趋势。
7017例患者接受了前庭神经鞘瘤（VS）切除术，其中464例（6.6%）患有NF2。在研究期间，散发性病例的人群调整手术率从11.8降至6.2（P <.001），NF2病例从0.3降至0.2（P =.01）。NF2与年龄较小（平均32.9岁对51.3岁）、其他并发症发生率较高（8.8%对4.4%）和面神经并发症发生率较高（32.3%对16.8%）、总费用较高（中位数70,106美元对46,395美元）、住院时间较长（中位数5天对4天）以及大型医院比例较高（80.4%对48.8%）相关（所有P <.001）。
散发性和NF2患者的前庭神经鞘瘤切除手术率均有所下降，但散发性病例下降更为显著。与散发性VS患者相比，NF2患者往往年龄较小，住院时间更长，相应的医院费用可能更高。
