Lesha Emal, Dugan John E, Cecia Arba, Nichols C Stewart, Orr Taylor J, Nezha Anxhela, Parikh Kara A, Khan Nickalus R
Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States.
Department of Neurological Surgery, Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee, United States.
J Neurol Surg B Skull Base. 2024 May 11;86(3):262-270. doi: 10.1055/a-2301-3761. eCollection 2025 Jun.
To conduct a systematic review of facial nerve hemangiomas (FNH), focusing on patient characteristics, management options, and treatment outcomes. A systematic review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, utilizing PubMed, EMBASE, Scopus, and Cochrane databases from inception to December 31, 2022. Literature sourced from various databases providing information on FNH cases. A total of 176 patients with FNH were included in the study, identified from 40 articles meeting inclusion criteria. Patient demographics, lesion characteristics, preoperative symptoms, surgical approaches, and postoperative outcomes, including House-Brackmann (HB) grades. Among the 1,682 initially identified articles, 40 were included in the final review. From these, a total of 176 patients (mean age = 42.7 ± 12.8, 51.1% male) were included for analysis. Bivariate analysis showed that patients with longer preoperative symptom duration and facial nerve sacrifice had significantly greater postoperative HB Grades ( < 0.001). Additionally, a strong positive correlation was observed between pre- and postoperative HB Grades (Spearman's rho = 0.649). Multivariable linear regression analysis showed that both facial nerve sacrifice (β = 0.86, 95% confidence interval [CI]: 0.38-1.34; < 0.001) and greater preoperative HB Grades (β = 0.36, 95% CI: 0.20-0.53; < 0.001) were associated with significantly greater postoperative HB Grades, but preoperative symptom duration did not persist as a significant predictor of postoperative HB Grades. FNHs are rare lesions of the skull base affecting the temporal bone. Our findings highlight the role of preoperative facial nerve function and intraoperative preservation of the facial nerve in predicting postoperative outcomes. Timely resection of lesions that prioritizes facial nerve preservation is critical to achieving optimal patient outcomes.
对面神经血管瘤（FNH）进行系统评价，重点关注患者特征、治疗选择和治疗结果。
按照PRISMA（系统评价和Meta分析的首选报告项目）指南进行系统评价，利用PubMed、EMBASE、Scopus和Cochrane数据库，检索时间从建库至2022年12月31日。
从各种数据库中获取有关FNH病例的文献资料。
本研究共纳入176例FNH患者，这些患者来自40篇符合纳入标准的文章。
记录患者人口统计学资料、病变特征、术前症状、手术方式以及术后结果，包括House-Brackmann（HB）分级。
在最初识别的1682篇文章中，40篇被纳入最终评价。从中共纳入176例患者（平均年龄=42.7±12.8岁，男性占51.1%）进行分析。双变量分析显示，术前症状持续时间较长和牺牲面神经的患者术后HB分级明显更高（P<0.001）。此外，术前和术后HB分级之间存在强正相关（Spearman相关系数=0.649）。多变量线性回归分析显示，牺牲面神经（β=0.86，95%置信区间[CI]：0.38-1.34；P<0.001）和术前较高的HB分级（β=0.36，95%CI：0.20-0.53；P<0.001）均与术后较高的HB分级显著相关，但术前症状持续时间并非术后HB分级的显著预测因素。
FNH是累及颞骨的罕见颅底病变。我们的研究结果强调了术前面神经功能和术中保留面神经在预测术后结果中的作用。优先保留面神经的病变及时切除对于实现最佳患者预后至关重要。
