Division of Neurological Surgery University of Missouri School of Medicine, 1 Hospital Drive, Columbia, MO 65212, USA.
Department of Pathology and Anatomical Sciences University of Missouri School of Medicine, 1 Hospital Drive, Columbia, MO 65212, USA.
J Clin Neurosci. 2020 Jun;76:114-117. doi: 10.1016/j.jocn.2020.04.029. Epub 2020 Apr 10.
Vestibular schwannomas are slow-growing tumors arising from the Schwann cells of the vestibular nerve. Scarpa's ganglion, the vestibular nerve ganglion, is located within the internal auditory meatus. Surgical treatment of vestibular schwannomas carries the potential of resecting Scarpa's ganglion along with the tumor. No prior studies have evaluated outcomes based on the presence of Scarpa's ganglion within tumor specimens. The neurosurgery patient records were queried for patients who underwent surgical resection of vestibular schwannomas at the University of Missouri Healthcare between January 1, 2008 and December 31, 2018. Inclusion criteria consisted of minimum age of 18, imaging demonstrating an eighth nerve tumor, surgical resection thereof, and a final pathological diagnosis of WHO grade I schwannoma. Data were collected retrospectively. The histological slides of the tumors were reviewed, and the presence or absence of the ganglion was noted. Outcomes analyzed included postoperative dizziness, hearing, and facial nerve function. Fifty-two patients met inclusion criteria. Ten (19%) resected tumors contained portions of the ganglion. No difference in risk of resection of ganglion occurred based on the surgical approach (p = 0.2454). Mean follow-up duration was 24.6 months ± 26.2 standard deviation. No differences in postoperative hearing or dizziness (p = 0.8483 and p = 0.3190 respectively) were present if Scarpa's ganglion was resected. House-Brackmann classification of facial nerve function at last follow-up was similar (p = 0.9190). Resection of Scarpa's ganglion with vestibular schwannomas does not increase risk of post-operative dizziness, facial nerve weakness, or hearing loss.
前庭神经鞘瘤是起源于前庭神经施旺细胞的缓慢生长的肿瘤。斯卡帕神经节，即前庭神经节，位于内听道内。手术治疗前庭神经鞘瘤有可能同时切除斯卡帕神经节和肿瘤。之前没有研究根据肿瘤标本中是否存在斯卡帕神经节来评估结果。我们查询了密苏里大学医疗保健中心在 2008 年 1 月 1 日至 2018 年 12 月 31 日期间接受前庭神经鞘瘤手术切除的患者的神经外科患者记录。纳入标准包括年龄至少 18 岁，影像学显示第八神经肿瘤，对其进行手术切除，以及最终的组织病理学诊断为世卫组织 I 级神经鞘瘤。数据是回顾性收集的。对肿瘤的组织学切片进行了审查，并记录了神经节的存在与否。分析的结果包括术后头晕、听力和面神经功能。52 名患者符合纳入标准。10 例（19%）切除的肿瘤含有部分神经节。基于手术方法，神经节切除的风险没有差异（p=0.2454）。平均随访时间为 24.6 个月±26.2 个标准差。如果切除了斯卡帕神经节，术后听力或头晕没有差异（p=0.8483 和 p=0.3190）。最后一次随访时 House-Brackmann 面神经功能分级相似（p=0.9190）。切除前庭神经鞘瘤的斯卡帕神经节不会增加术后头晕、面神经无力或听力损失的风险。
