后颅窝容积对前庭神经鞘瘤切除术后临床结局的影响。

Influence of Posterior Fossa Volume on Clinical Outcomes After Vestibular Schwannoma Resection.

作者信息

Macielak Robert J, Harris Michael S, Kirsch Claudia F, Prevedello Luciano M, Adunka Oliver F

机构信息

*The Ohio State University College of Medicine †Department of Otolaryngology-Head & Neck Surgery, Neurotology Division, The Ohio State University ‡Department of Radiology, Division of Neuroradiology, The Ohio State University, Columbus, Ohio.

出版信息

Otol Neurotol. 2016 Sep;37(8):1155-61. doi: 10.1097/MAO.0000000000001128.

DOI:10.1097/MAO.0000000000001128

PMID:27362739

Abstract

OBJECTIVES

To determine the influence of posterior fossa dimensions on surgical outcomes after vestibular schwannoma management.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary care academic medical center.

PATIENTS

Patients with sporadic vestibular schwannomas who underwent surgical resection via retrosigmoid or translabyrinthine techniques.

INTERVENTIONS

Diagnostic.

MAIN OUTCOME MEASURES

One and two-way analysis of variance (ANOVAs) of the cohort based on volumetric and clinical outcome groupings.

RESULTS

A total of 95 patients were identified. A one-way ANOVA looking at the entire cohort of patients showed that outcomes like surgical time (p < 0.001) and whether a Good Outcome (House-Brackmann score of 1 or 2, no complications, and a complete resection) was achieved (p = 0.009) correlated very well with preoperative tumor volume, but not with posterior fossa volume (p = 0.412 and p = 0.345, respectively). However, in medium sized tumors, House-Brackmann group was correlated with posterior fossa volume (p = 0.032).

CONCLUSIONS

The present data suggest a small effect of posterior fossa size on some clinical outcomes in medium sized vestibular schwannomas.

摘要

目的

确定后颅窝尺寸对前庭神经鞘瘤治疗后手术结果的影响。

研究设计

回顾性病历审查。

研究地点

三级医疗学术医学中心。

患者

通过乙状窦后或经迷路技术接受手术切除的散发性前庭神经鞘瘤患者。

干预措施

诊断性。

主要观察指标

基于体积和临床结果分组对队列进行单因素和双因素方差分析（ANOVA）。

结果

共纳入95例患者。对整个患者队列进行的单因素方差分析表明，手术时间（p<0.001）以及是否取得良好结果（House-Brackmann评分为1或2，无并发症且完全切除）（p = 0.009）等结果与术前肿瘤体积密切相关，但与后颅窝体积无关（分别为p = 0.412和p = 0.345）。然而，在中等大小的肿瘤中，House-Brackmann分组与后颅窝体积相关（p = 0.032）。