The anatomical location and course of the facial nerve in vestibular schwannomas : a study of 163 surgically treated cases.
OBJECTIVE
The aim of this study was to identify the anatomical location and course of the facial nerve (FN) and their relationship to the tumor size in surgically treated vestibular schwannomas.


METHODS
A retrospective study was conducted on 163 patients who had been treated by the microsurgical resection for a newly diagnosed vestibular schwannoma between 1995 and 2005 (mean age of 46.1 years; 108 females and 55 males). Surgery was carried out via retrosigmoid approach in all patients with the electromyographic monitoring for the FN function. The anatomical location and course of the FN along the tumor surface were verified in each patient during the microsurgery, and were classified into 4 groups : 1) the FN displaced along the ventral and superior surface of the tumor (VS); 2) the ventral and central (VC); 3) the ventral and inferior (VI); and 4) the dorsal (Do).


RESULTS
THE FN DISPLACEMENT WAS IDENTIFIED AS THE FOLLOWINGS : VS in 91 patients (55.8%); VC in 57 (35.0%); VI in 14 (8.6%); and Do in 1 (0.6%). In the subgroup with tumors less than 2 cm in diameter (n=23), the FN was displaced along the ventral and central surface of the tumor in the majority (65.2%), whereas, in the patients with tumors larger than 2cm (n=140), it was displaced along the ventral and superior surface most frequently (59.3%).


CONCLUSIONS
The FN can be displaced variably in vestibular schwannomas, and most frequently along the ventral and superior surface of the tumor, especially in large ones.
Bae
Chae Wan
CW
Department of Neurological Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Cho
Young Hyun
YH
Hong
Seok Ho
SH
Kim
Jeong Hoon
JH
Lee
Jung-Kyo
JK
Kim
Chang Jin
CJ