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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

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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 (Burdenko's Journal of Neurosurgery)
 
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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

List of references:

  1. Goldbrunner R, Weller M, Regis J, Lund-Johansen M, Stavrinou P, Reuss D, Evans DG, Lefranc F, Sallabanda K, Falini A, Axon P, Sterkers O, Fariselli L, Wick W, Tonn JC. EANO guideline on the diagnosis and treatment of vestibular schwannoma. Neuro-Oncology. 2020;22(1):31-45.  https://doi.org/10.1093/neuonc/noz153
  2. Kshettry V, Hsieh J, Ostrom Q, Kruchko C, Barnholtz-Sloan J. Incidence of vestibular schwannomas in the United States. Journal of Neuro-Oncology. 2015;124(2):223-228.  https://doi.org/10.1007/s11060-015-1827-9
  3. Ostrom Q, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan J. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014-2018. Neuro-Oncology. 2021;23(12 suppl 2):iii1-iii105. https://doi.org/10.1093/neuonc/noab200
  4. Gupta V, Thakker A, Gupta K. Vestibular Schwannoma: What We Know and Where We are Heading. Head and Neck Pathology. 2020;14(4):1058-1066. https://doi.org/10.1007/s12105-020-01155-x
  5. Grinblat G, Dandinarasaiah M, Braverman I, Taibah A, Lisma D, Sanna M. Large and giant vestibular schwannomas: overall outcomes and the factors influencing facial nerve function. Neurosurgical Review. 2021;44(4):2119-2131. https://doi.org/10.1007/s10143-020-01380-6
  6. Killeen DE, Barnett SL, Mickey BE, Hunter JB, Isaacson B, Kutz JW Jr. The Association of Vestibular Schwannoma Volume With Facial Nerve Outcomes After Surgical Resection. Laryngoscope. 2021;131(4):E1328-E1334. https://doi.org/10.1002/lary.29141
  7. Mastronardi L, Gazzeri R, Barbieri F, Roperto R, Cacciotti G, Sufianov A. Postoperative Functional Preservation of Facial Nerve in Cystic Vestibular Schwannoma. World Neurosurgery. 2020;143:e36-e43.  https://doi.org/10.1016/j.wneu.2020.04.018
  8. Troude L, Boucekine M, Montava M, Lavieille J, Régis J, Roche P. Predictive Factors of Early Postoperative and Long-Term Facial Nerve Function After Large Vestibular Schwannoma Surgery. World Neurosurgery. 2019;127:599-608.  https://doi.org/10.1016/j.wneu.2019.03.218
  9. Larin AI, Konovalov AN, Kasumova SYu. Microtopography of the structures of the cerebellopontine angle in acoustic neuromas. Burdenko’s Journal of Neurosurgery. 1979;(5):3-12. (In Russ.).
  10. Yasargil MG. A legacy of microneurosurgery: memoirs, lessons, and axioms. Neurosurgery. 1999;45(5):1025-1092. https://doi.org/10.1097/00006123-199911000-00014
  11. Koerbel A, Gharabaghi A, Safavi-Abbasi S, Tatagiba M, Samii M. Evolution of vestibular schwannoma surgery: the long journey to current success. Neurosurgical Focus. 2005;18(4):e10.  https://doi.org/10.3171/foc.2005.18.4.11
  12. Harati A, Scheufler K, Schultheiss R, Tonkal A, Harati K, Oni P, Deitmer T. Clinical features, microsurgical treatment, and outcome of vestibular schwannoma with brainstem compression. Surgical Neurology International. 2017;8:45.  https://doi.org/10.4103/sni.sni_129_16
  13. Horsfall H, Khan D, Collins J, Cooke S, Freeman S, Gurusinghe N, Hampton S, Hardwidge C, Irving R, Kitchen N, King A, Khal S, Koh C, Leonard C, Marcus H, Muirhead W, Obholzer R, Pathmanaban O, Robertson I, Shapey J, Stoyanov D, Teo M, Tysome J, Saeed S, Grover P. Generating operative workflows for vestibular schwannoma resection: a two-stage Delphi consensus in collaboration with British Skull Base Society. Part 1: the retrosigmoid approach. Journal of Neurological Surgery Part B Skull Base. 2022;84(5):423-432.  https://doi.org/10.1055/a-1886-5500
  14. Samii M, Matthies C. Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve--preservation and restitution of function. Neurosurgery. 1997;40(4):684-694; discussion 694-695.  https://doi.org/10.1097/00006123-199701000-00002
  15. Wu Y, Wei C, Wang P, Zhang Y, Wu Y, Xue Y, Zhao T, Qu Y. Application of Subperineural Resection Technique in Vestibular Schwannomas: Surgical Efficacy and Outcomes in 124 patients. Frontiers in Oncology. 2022;12:849109. https://doi.org/10.3389/fonc.2022.849109
  16. Totten D, Connell N, Howser L, Colomb E. Facial Nerve Preservation With Inferior Long-Axis Dissection of Large Vestibular Schwannomas. Otology & neurotology. 2023;44(1):66-71.  https://doi.org/10.1097/MAO.0000000000003753
  17. Mastronardi L, Cacciotti G, Roperto R, Di Scipio E, Tonelli M, Carpineta E. Position and Course of Facial Nerve and Postoperative Facial Nerve Results in Vestibular Schwannoma Microsurgery. World Neurosurgery. 2016;94:174-180.  https://doi.org/10.1016/j.wneu.2016.06.10718
  18. Dhayalan D, Perry A, Graffeo C, Tveiten Ø, Muñoz Casabella A, Pollock B, Driscoll C, Carlson M, Link M, Lund-Johansen M. Salvage radiosurgery following subtotal resection of vestibular schwannomas: does timing influence tumor control? Journal of Neurosurgery. 2022;138(2):420-429.  https://doi.org/10.3171/2022.5.JNS22249
  19. Thai N, Mai N, Vuong N, Tin N, Karam D, Refaey M, Shahin K, Soliman A, Al Khudari, R, Thuan T, Sabbah G, El-Qushayri A, Karimzadeh S, Hirayama K, Huy N. Treatment for vestibular schwannoma: Systematic review and single arm meta-analysis. American Journal of Otolaryngology. 2022;43(2):103337. https://doi.org/10.1016/j.amjoto.2021.103337
  20. Dumot C, Pikis S, Mantziaris G, Xu Z, Anand R, Nabeel A, Sheehan D, Sheehan K, Reda W, Tawadros S, Abdel Karim K, El-Shehaby A, Emad Eldin R, Peker S, Samanci Y, Kaisman-Elbaz T, Speckter H, Hernández W, Isidor J, Tripathi M, Sheehan J. Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in young patients: a multi-institutional study. Journal of Neurooncology. 2022;160:201-208.  https://doi.org/10.1007/s11060-022-04134-0
  21. Samii M, Gerganov V, Samii A. Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients. Journal of Neurosurgery. 2006;105(4):527-535.  https://doi.org/10.3171/jns.2006.105.4.527

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