Pre- and intra-operative prognostic factors of facial nerve function in cerebellopontine angle surgery
Gazia, Francesco (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Callejo, Àngela (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pérez-Grau, Marta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Lareo, Susana (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Prades, José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Roca-Ribas, Francesc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Amilibia, Emilio (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Date:	2022
Abstract:	Purpose: The study assesses whether pre- and intraoperative factors linked to electromyography and direct electrical stimulation (DES) of facial nerve can predict facial nerve function in the short- (12 days) and long-term (1 year) after cerebellopontine angle (CPA) tumor resection. Methods: 157 patients who underwent surgical resection of CPA tumors with facial nerve monitoring. Pre-operative factors (age, tumor size, pure tone average), surgical time and intra-operative parameters regarding facial function, minimum stimulation threshold (MST), compound muscle action potential (CMAP) and the diference between proximal and distal CMAP (DPDC) were evaluated. Results: A correlation between tumor size, MST, CMAP and facial function in both short and long term was found. A higher grade of immediate facial paralysis corresponded to a higher risk of poor outcome after one year. A postoperative House-Brackmann (HB) score of V or VI was correlated with poor outcome in 88. 8% and 93. 8% of cases. A risk of HB 3 or more, in the long term, was correlated with a tumor size of 20. 2 mm. Using an MST of 0. 1 mA, for long-term predictions, sensitivity and specifcity were 0. 62 (95% CI 0. 46-0. 75) and 0. 73 (95% CI 0. 61-0. 82), respectively. With a CMAP cut-of<200 µV, for long-term prediction, sensitivity was 0. 73 (95% CI 0. 53-0. 87) and specifcity 0. 73 (95% CI 0. 55-0. 85). Conclusion: The assessment based on the cut-ofs described increases the ability to predict facial function. Improving predictive accuracy enables surgeons to address patients' expectations and to establish an intervention timeline for planning facial reanimation.
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Electromyography ; Stimulation threshold ; Vestibular schwannoma ; Muscle action potential ; Prognosis ; Nerve monitoring ; Facial nerve
Published in:	European Archives of Oto-Rhino-Laryngology, Juliol 2022

DOI: 10.1007/s00405-022-07556-8
PMID: 35907000

8 p, 693.3 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles