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Management strategy of facial nerve tumors
Objective To elucidate the clinical behavior, treatment and outcomes of facial nerve tumors and discuss strategy in management of facial nerve tumors.
Methods In this study, a total of 178 patients with facial nerve tumors underwent serial observation or microsurgery from 2002 to 2017 was analyzed. 132 patients underwent surgical removal and 46 serial observation. In surgical group, 122 patients were diagnosed as facial nerve schwannomas and 10 patients were facial nerve hemangioma. The main outcomes included tumor removal, facial nerve function, pure-tone average from pre- to postoperative and surgical complications.
Results Three most frequent occurrence sites are geniculate ganglion, internal auditory canal and labyrinthine segment. In 10 patients with facial nerve hemangioma, complete hearing loss occurred in all 10 patients and primary end-to-end anastomosis was performed. In 122 patients with facial nerve schwannomas, facial nerve rerouting and anastomosis was performed in 20 patients (16.4 %), facial-hypoglossal nerve anastomosis in 52 patients (42.6 %) and sural nerve grafting in 50 patients (41.0 %). Patients were followed up for at least 1 year after treatment, and MRI showed no evidence of tumor regrowth. Various degree recovery in facial nerve function were observed.
Conclusions Good results can be achieved in patients with facial nerve tumors. Treatment strategy and surgical approaches should be changed by different patients and different tumors. Facial nerve function is always the most important issue be considered.
10 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York