Department of Neurosurgery, Faculty of Medicine, Damascus University, Damascus, Syria.
Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria.
J Med Life. 2024 Apr;17(4):426-431. doi: 10.25122/jml-2024-0055.
This multicenter retrospective cohort study aimed to evaluate the effectiveness of the retrosigmoid surgical approach in decompressing vestibular schwannomas, focusing on tumor decompression, neurological function preservation, and postoperative complications. A cohort of 60 patients, operated between 2016 and 2019, was analyzed for age, sex, symptoms, tumor size, surgery duration, complications, mortality, and facial/auditory functions using established criteria. Hearing loss was observed in 80% of patients, mainly progressive, with tumor size emerging as a critical prognostic factor. Facial weakness affected 10% of patients preoperatively; postoperatively, 35% of patients had affected facial nerve function, with 10% exhibiting poor or no facial nerve function, linked to resection extent rather than tumor size. Tinnitus was more prevalent with larger tumors, whereas headaches were common irrespective of size. Balance disorders improved after surgery, especially in case of larger tumors. Functional recovery varied, with 41.67% of patients returning to their previous activity within 4 months, 25% within 4-12 months, and 33.33% remaining inactive. The mortality rate was low at 3.3 %, with two deaths out of 60 patients after surgery. This analysis highlights surgery risks for vestibular schwannomas (e.g., facial nerve decline, tinnitus, headaches), but also emphasizes benefits like improved balance and low mortality. Many patients regain professional activity, stressing the importance of informed treatment decisions for this condition.
这项多中心回顾性队列研究旨在评估乙状窦后入路在听神经瘤减压中的有效性，重点关注肿瘤减压、神经功能保护和术后并发症。对 2016 年至 2019 年间接受手术的 60 例患者的年龄、性别、症状、肿瘤大小、手术持续时间、并发症、死亡率和面部/听觉功能进行了分析，采用了既定的标准。80%的患者出现听力损失，主要是进行性的，肿瘤大小是一个关键的预后因素。10%的患者术前存在面神经无力；术后，35%的患者面神经功能受到影响，其中 10%的患者面神经功能不良或丧失，与切除范围而非肿瘤大小有关。耳鸣在较大肿瘤中更为常见，而头痛则与肿瘤大小无关，较为常见。平衡障碍在手术后得到改善，尤其是在较大肿瘤的情况下。功能恢复情况各不相同，4 个月内有 41.67%的患者恢复到术前活动水平，4-12 个月内有 25%的患者恢复到术前活动水平，33.33%的患者仍无法活动。死亡率较低，为 3.3%，60 例患者中有 2 例死亡。这项分析突出了听神经瘤手术的风险（例如面神经下降、耳鸣、头痛），但也强调了平衡改善和低死亡率等益处。许多患者恢复了职业活动，这强调了针对这种情况做出明智治疗决策的重要性。
