Analise tardia do grau de paralisia facial em pacientes operados de Schwannoma vestibular / Long-term facial palsy evaluation folowing vestibular Schwannoma surgery

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Introduction: The evaluation of facial palsy is an important issue after vestibular schwannoma (VS) surgery due to its physical and social morbidity. Its reversibility is a . persistent questioning on the part of the patient and the neurosurgeon. Objetives: This study aimed to evaluate facial palsy in patients undergoing VS resection and to correia te tumor size and facial function in a long-term follow-up. Method: Transversal study of 20 patients with VS operated in HCIUNICAMP between January 1999 and October 2002 by the retrosigmoid approach. Facial function was evaluated by House-Brackmann Scale before, immediate and 18 months or longer after surgery. Tumors were classified as small (::2.0 cm), medium (2.1-4.0 cm) or large (>4.0 cm). The Student t test was applied for statistic analysis. ResuIts: The mean age ofpatients was 51 years (range 17 to 77 years) and 75% of the cases were females. Mean tumor size was 3.3 8 cm. The longest time of postoperative evaluation was 3 years and 10 months and the shorter one was 1 Year and 7 months (mean time of3 years and 10 months). In the immediate postoperative evaluation, 65% ofpatients presented facial palsy of different grades. Improvement of facial nerve function (at least of one grade) occurred in 53% in the long-term follow-up. Patients with unsatisfactory improvement in the final evaluation had alreagy had some degree of this palsy preoperatively. There was a statistically significant difference in facial nerve outcome in the long-term follow-up when tumor size was considered (p<0,05). Conclusions: VS surgery has as morbidity the facial palsy that can be definitive or temporary. The majority of patients had improvement this disfunction in a mean time of3 years and 10 months after VS surgery (65%). Analysis ofthe grade offacial palsy allowed the accompaniment ofthe evolution of these patients and the identification of tumor size as factor associated with the postoperative unfavorable prognostic in the long-term follow-up

ASSUNTO(S)

neuroma paralisia facial facial paralysis diagnosis accoustic tumor tumors neuroma acustico neuroma acustico - diagnostico

Documentos Relacionados