title: Comparison of outcomes of peripheral nerve schwannoma excision in neurofibromatosis type 2 patients and non-neurofibromatosis type 2 patients: A case control study.
abstract: BACKGROUND
  Patients with neurofibromatosis type 2 (NF2) are an important subgroup of patients undergoing peripheral nerve schwannoma excision, however data on their outcomes are lacking. Co-existing peripheral neuropathy can complicate the clinical presentation and recovery in NF2. We designed a study to compare outcomes of peripheral nerve schwannoma excision in NF2 patients with excision of isolated, sporadic schwannomas in non-NF2 patients.
  
  
  METHODS
  30 peripheral nerve schwannoma excisions from 15 NF2 patients were compared to 30 excised isolated schwannomas. These were matched for age, size, nerve and level of involvement. Final outcomes were scored on a scale of 0 (no improvement) to 3 (complete symptom resolution). Data were analysed by McNemars test and Wilcoxen matched pairs test.
  
  
  RESULTS
  NF2 patients had multiple lesions and more pre-operative weakness (p = 0.041) and sensory loss (p = 0.133) compared to controls. Post-operative neurological morbidity occurred in both groups after schwannoma excision. Final outcome scores of 2.4 in NF2 and 2.2 in controls indicate great improvement or complete resolution in the majority.
  
  
  CONCLUSIONS
  Outcomes in the NF2 group are not different to controls, despite NF2 patients having more significant pre-operative deficit and co-existing neuropathology. These findings suggest that surgical intervention should be offered to NF2 patients with peripheral nerve schwannomas.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Oxford University Hospitals, Headley Way, Oxford, OX3 9DU, UK. Electronic address: charlottebendon@googlemail.com.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Bendon
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Oxford University Hospitals, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Dominic
authors.initials: D
authors.lastname: Furniss
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Oxford University Hospitals, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Henk P
authors.initials: HP
authors.lastname: Giele
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D016518:Neurofibromatosis 2 / Q000175:diagnosis / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Peripheral nerve sheath tumour; Peripheral nerve surgery; Schwannoma; Type 2 neurofibromatosis