Suppr超能文献

经乙状窦后入路半坐位手术治疗库斯3级和4级前庭神经鞘瘤时肿瘤伸长对面神经预后的影响

The Impact of Tumor Elongation on Facial Nerve Outcome after Surgery for Koos Grade 3 and 4 Vestibular Schwannomas in the Semi-Sitting Position via the Retrosigmoid Approach.

作者信息

Glieme Franziska, Haddad Lisa, Arlt Felix, Vychopen Martin, Seidel Clemens, Barrantes-Freer Alonso, Güresir Erdem, Wach Johannes

机构信息

Department of Neurosurgery, University Hospital Leipzig, University of Leipzig, 04103 Leipzig, Germany.

Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany.

出版信息

J Clin Med. 2024 Sep 8;13(17):5319. doi: 10.3390/jcm13175319.

Abstract

Facial nerve paralysis is a severe dysfunction after vestibular schwannoma (VS) surgery. This monocentric study analyzed 61 patients who underwent sporadic VS surgery in a standardized manner. The primary endpoint was the facial nerve outcome (FNO) at 3 months after VS surgery. FNO was dichotomized into "good" (House-Brackmann (HB) score ≤ 2) and "poor" (HB > 2). Poor FNO was observed in 11 patients (18.0%) at 3 months after VS surgery. Radiomic tumor shape features were analyzed, and the AUC of elongation in the prediction of a poor HB at 3 months was 0.70 (95% CI: 0.56-0.85, = 0.03) and the optimum threshold value (≤/>0.35) yielded a sensitivity and specificity of 64.0% and 75.4%, respectively. Multivariable logistic regression analyses considering the extent of resection (</≥93.4%), preoperative tumor volume (</≥2.6 cm), age (</≥55), sex (female/male), and elongation (≤/>0.35) revealed that more elongated VSs (≤0.35; OR: 5.8; 95%CI: 1.2-28.2; = 0.03) and those with an increased EoR (≥93.4%; OR: 6.5; 95%CI: 1.0-42.5; = 0.05) are independently associated with poorer FNO at 3 months after surgery. Highly elongated VS shape seems to be a risk factor for worsened facial nerve outcome at 3 months after surgery for Koos grade 3 and 4 tumors.

摘要

面神经麻痹是前庭神经鞘瘤(VS)手术后的一种严重功能障碍。这项单中心研究分析了61例以标准化方式接受散发性VS手术的患者。主要终点是VS手术后3个月时的面神经结果(FNO)。FNO被分为“良好”(House-Brackmann(HB)评分≤2)和“不良”(HB>2)。VS手术后3个月时,11例患者(18.0%)出现不良FNO。分析了放射组学肿瘤形状特征,预测3个月时HB不良的伸长率的AUC为0.70(95%CI:0.56-0.85,P = 0.03),最佳阈值(≤/>0.35)产生的敏感性和特异性分别为64.0%和75.4%。多变量逻辑回归分析考虑了切除范围(</≥93.4%)、术前肿瘤体积(</≥2.6 cm)、年龄(</≥55岁)、性别(女性/男性)和伸长率(≤/>0.35),结果显示,形状更细长的VS(≤0.35;OR:5.8;95%CI:1.2-28.2;P = 0.03)以及切除范围增加的VS(≥93.4%;OR:6.5;95%CI:1.0-42.5;P = 0.05)与术后3个月时较差的FNO独立相关。对于Koos 3级和4级肿瘤,高度细长的VS形状似乎是术后3个月面神经结果恶化的一个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/266d/11396018/d988581d77b7/jcm-13-05319-g001.jpg

相似文献

3
Long-term tumor control in Koos grade IV vestibular schwannomas without the need for gross-total resection.
J Neurosurg. 2023 Dec 1;140(6):1591-1604. doi: 10.3171/2023.9.JNS231316. Print 2024 Jun 1.
4
The behavior of residual tumors and facial nerve outcomes after incomplete excision of vestibular schwannomas.
J Neurosurg. 2014 Jun;120(6):1278-87. doi: 10.3171/2014.2.JNS131497. Epub 2014 Apr 11.
8
Facial Nerve Outcomes After Vestibular Schwannoma Microsurgical Resection in Neurofibromatosis Type 2.
Otolaryngol Head Neck Surg. 2021 Apr;164(4):850-858. doi: 10.1177/0194599820954144. Epub 2020 Sep 22.
10
The impact of the MIB-1 index on facial nerve outcomes in vestibular schwannoma surgery.
Acta Neurochir (Wien). 2020 May;162(5):1205-1213. doi: 10.1007/s00701-020-04283-z. Epub 2020 Mar 9.

本文引用的文献

1
Long-term tumor control in Koos grade IV vestibular schwannomas without the need for gross-total resection.
J Neurosurg. 2023 Dec 1;140(6):1591-1604. doi: 10.3171/2023.9.JNS231316. Print 2024 Jun 1.
3
How to position the patient? A meta-analysis of positioning in vestibular schwannoma surgery the retrosigmoid approach.
Front Oncol. 2023 Feb 1;13:1106819. doi: 10.3389/fonc.2023.1106819. eCollection 2023.
4
Vestibular Schwannoma Cerebellopontine Angle Position Impacts Facial Outcome.
Laryngoscope. 2022 May;132(5):1093-1098. doi: 10.1002/lary.29922. Epub 2021 Oct 27.
6
Microsurgical Treatment and Follow-Up of KOOS Grade IV Vestibular Schwannoma: Therapeutic Concept and Future Perspective.
Front Oncol. 2020 Nov 20;10:605137. doi: 10.3389/fonc.2020.605137. eCollection 2020.
7
Prediction of Vestibular Schwannoma Enlargement After Radiosurgery Using Tumor Shape and MRI Texture Features.
Otol Neurotol. 2021 Mar 1;42(3):e348-e354. doi: 10.1097/MAO.0000000000002938.
8
Intentional Subtotal Resection of Vestibular Schwannoma: A Reexamination.
J Neurol Surg B Skull Base. 2020 Apr;81(2):136-141. doi: 10.1055/s-0039-1679898. Epub 2019 Mar 1.
9
The impact of the MIB-1 index on facial nerve outcomes in vestibular schwannoma surgery.
Acta Neurochir (Wien). 2020 May;162(5):1205-1213. doi: 10.1007/s00701-020-04283-z. Epub 2020 Mar 9.
10
Gamma knife surgery in the treatment of intracanalicular vestibular schwannomas.
Acta Neurol Scand. 2020 May;141(5):415-422. doi: 10.1111/ane.13220. Epub 2020 Jan 30.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验