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Alekseev I.M.

Pirogov National Medical Surgical Center

Ovchinnikov V.A.

Pirogov National Medical Surgical Center

Chupalenkov S.M.

Pirogov National Medical Surgical Center

Zuev A.A.

Pirogov National Medical Surgical Center

Our approach to the treatment of vestibular schwannomas with arachnoid dissection of the facial nerve

Authors:

Alekseev I.M., Ovchinnikov V.A., Chupalenkov S.M., Zuev A.A.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2024;88(4): 38‑49

DOI: 10.17116/neiro20248804138

Read: 1111 times

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Table of contents

OUR APPROACH TO THE TREATMENT OF VESTIBULAR SCHWANNOMAS WITH ARACHNOID DISSECTION OF THE FACIAL NERVE
OUR APPROACH TO THE TREATMENT OF VESTIBULAR SCHWANNOMAS WITH ARACHNOID DISSECTION OF THE FACIAL NERVE

To cite this article:

Alekseev IM, Ovchinnikov VA, Chupalenkov SM, Zuev AA. Our approach to the treatment of vestibular schwannomas with arachnoid dissection of the facial nerve. Burdenko's Journal of Neurosurgery. 2024;88(4):38‑49. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248804138

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

Preserving the function of the facial nerve is extremely important in surgery for vestibular schwannomas. Two methods of arachnoid dissection are described for resection of vestibular schwannoma via retrosigmoid approach (from the brain stem and internal auditory canal).

OBJECTIVE

To evaluate the results of arachnoid dissection of the facial nerve from internal auditory canal when resecting the vestibular schwannoma.

MATERIAL AND METHODS

We analyzed 61 patients with vestibular schwannomas. Patients were divided into 2 groups depending on surgical technique. We estimated facial nerve function before and after surgery, preoperative dimension of vestibular schwannoma and extent of resection. The influence of various factors on extent of resection and postoperative facial nerve function was studied.

RESULTS

Vestibular schwannoma resection from the brain stem was performed in 30 patients, arachnoid dissection — in 31 patients. There was no significant between-group difference. Gross total resection was performed in 78.7% of cases. Both techniques demonstrated similar results regarding extent of resection. Arachnoid dissection showed the advantage regarding facial nerve function immediately after surgery (p=0.012) and 6 months later (p<0.001). Normal facial nerve function in 6 months after arachnoid dissection was observed in 80.7% of patients. Preoperative dimension of tumor influenced facial nerve function in addition to technique of resection (p=0.001).

CONCLUSION

We identified the factors influencing facial nerve function after resection of vestibular schwannoma. Surgical technique was the most significant factor. These data expand and popularize arachnoid dissection in surgery of vestibular schwannomas.

Keywords:

vestibular schwannomas
arachnoid dissection
retrosigmoid approach

Authors:

Alekseev I.M.

Pirogov National Medical Surgical Center

Ovchinnikov V.A.

Pirogov National Medical Surgical Center

Chupalenkov S.M.

Pirogov National Medical Surgical Center

Zuev A.A.

Pirogov National Medical Surgical Center

Received:

07.07.2023

Accepted:

31.05.2024

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