[Predictive factors of facial palsy of the acoustic neurinoma after retrosigmoid surgery: 230 cases].
OBJECTIVE
To determine predictive factors influencing postoperative facial palsy during retro sigmoid approach in vestibular schwannoma surgery.


METHODS
Retrospective study over 230 patients with vestibular schwannoma, mostly stade I and II, operated by retro sigmoid approach, by the same oto neuro chirurgical team between 1993 and 2004. Pre and post operative parameters taken into consideration: quantitative: age and sex, audiometric parameters, duration of clinical symptoms; qualitative: tumor anatomic factors and facial nerve function according to House Brackmann classification.


RESULTS
8 days after surgery, 92% of patients have a normal or subnormal facial nerve function, 5% a facial paresis and 3% a paralysis. After one year, only 4% of patients still have a grade III to VI paralysis. Latency of vertigo with facial nerve paralysis is 4.33 vs. 1.97 year in absence of paralysis. Hearing conservation is 85% without facial nerve paralysis vs. 58% with facial nerve paralysis; Wave III latency (PEAP) with facial nerve paralysis is 4.54 vs. 4.28 ms if not.


CONCLUSIONS
Significant predictive factors of facial nerve palsy outcome are: age, post surgery hearing conservation, wave III latency, difficulty in tumor dissection, vertigo latency.
Bouchene
M
M
Service d'ORL, oto-neuro-chirurgie, Centre hospitalier Lyon Sud, 69495 Pierre-Bénite Cedex, France.
Pavillon
S
S
Zaouche
S
S
Boulud
B
B
Dubreuil
C
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005071:Evoked Potentials; D005154:Facial Nerve / Q000502:physiology; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D014717:Vertigo / Q000209:etiology