Yıl: 2021 Cilt: 45 Sayı: 1 Sayfa Aralığı: 5 - 9 Metin Dili: İngilizce İndeks Tarihi: 15-11-2021

Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring

Öz:
Objective: Intraoperative neurophysiological monitoring (IONM) is commonly used in preserving the function of the facial nerve (FN)during surgery for cerebellopontine angle (CPA) lesions. In this study, we aimed to compare the outcomes of FN function in patients whowere treated for CPA lesions with or without IONM.Methods: This study included 37 patients (22 women, 15 men). The patients were divided in two groups based on whether IONM wasused (group 1) or not (group 2). The FN function was graded according to House–Brackmann (HB) Score. HB scores of 1–3 and 4–6 wereconsidered favorable and unfavorable outcomes, respectively. Demographic information, surgical resection rates, type of pathology, andFN function were evaluated retrospectively. Comparisons between groups were conducted using nonparametric tests.Results: The mean age of the patient group was 45.2±14.82 years and the range was 16–72 years. There were 17 patients in group 1and 20 patients in group 2. At the 1-year examination, 6 patients (35.3%) in group 1 and 2 patients (10%) in group 2 had unfavorableFN function. A 1-year postoperative comparison of the groups, in terms of the presence of disfiguring FN palsy, showed a statisticallysignificant difference (p=0.03).Conclusion: The use of IONM during surgery of CPA lesions promoted the preservation of FN function with a secondary benefit of facilitating maximal resection.
Anahtar Kelime:

Serebellopontin Açı Lezyonlarının Cerrahi Tedavisinde İntraoperatif Nöromonitorizasyon Kullanılan ve Kullanılmayan Olguların Fasiyal Sinir Sonuçlarının Karşılaştırılması

Öz:
Amaç: İntraoperatif nörofizyolojik monitörizasyon (İONM)serebellopontin köşe (SPK) lezyonları cerrahisinde fasiyal sinir (FS) fonksiyonunu korumak için kullanılır. Bu çalışma, SPK lezyonlarının cerrahi tedavisi esnasında İONM kullanılan ve kullanılmayan hastalarda, FS işlevinin sonuçlarını karşılaştırmayı amaçlamaktadır. Yöntemler: Bu çalışmaya 37 hasta dahil edildi. Hasta grubu cerrahi tedavi esnasında İONM kullanılıp kullanılmamasına göre iki gruba ayrıldı. Grup 1 İONM kullanılmayan hastaları ve Grup 2 İONM kullanılan hastaları içerdi. FS işlevi, House Brackman (HB) skoruna göre derecelendirildi. HB 1-3 iyi sonuç olarak ve HB 4-6 kötü sonuç olarak kabul edildi. Demografik bilgiler, cerrahi rezeksiyon oranları, patoloji tipi ve FS işlevi geriye dönük olarak değerlendirildi. Bulgular: Bu çalışmada 22’si kadın 15’i erkek olmak üzere 37 hasta değerlendirildi. Hasta grubunun yaş ortalaması 45,2±14,82, 16 ile 72 arasında idi. Grup 1’de 17 hasta, grup 2’de 20 hasta vardı. Grup 1’de bir yıllık muayenede FN sonucu kötü olan 6 hasta vardı (%35,3) grup 2’de (%10) sadece 2 hastada kötü FN sonucu görüldü. Ameliyat sonrası birinci yılda, yüzde belirgin çarpıklığa sebep olan FS felci açısından gruplar karşılaştırıldığında istatistiksel olarak anlamlı farklılık saptandı (p=0,03). Sonuç: SPK lezyonlarının cerrahisi sırasında İONM kullanımı, FS işlevinin korunmasını sağlamaktadır; ayrıca daha geniş rezeksiyon oranlarına ulaşılmasını kolaylaştırmaktadır
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Nellis JC, Ishii M, Byrne PJ, Boahene KDO, Dey JK, Ishii LE. Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients. JAMA Facial Plastic Surg 2017; 19: 190-6. [Crossref]
  • 2. Macgregor FC. Facial disfigurement: problems and management of social interaction and implications for mental health. Aesthetic Plast Surg 1990; 14: 249-57. [Crossref]
  • 3. Macdonald DB. Intraoperative motor evoked potential monitoring: overview and update. J Clin Monit Comput 2006; 20: 347-77. [Crossref]
  • 4. Toleikis JR, American Society of Neurophysiological M. Intraoperative monitoring using somatosensory evoked potentials. A position statement by the American Society of Neurophysiological Monitoring. J Clin Monit Comput 2005; 19: 241-58. [Crossref]
  • 5. Taşkıran E, Küçükyürük B. Intraoperative Neurophysiology Practice in the Surgical Treatment of Posterior Fossa Lesions: Cerrahpaşa Experience. İstanbul Med J 2020; 21: 344-9. [Crossref]
  • 6. Lalwani AK, Butt FY, Jackler RK, Pitts LH, Yingling CD. Facial nerve outcome after acoustic neuroma surgery: a study from the era of cranial nerve monitoring. Otolaryngol Head Neck Surg. 1994; 111: 561-70. [Crossref]
  • 7. Frith C. Role of facial expressions in social interactions. Philos Trans R Soc Lond B Biol Sci 2009; 364: 3453-8. [Crossref]
  • 8. Shaw WC. Folklore surrounding facial deformity and the origins of facial prejudice. Br J Plast Surg 1981; 34: 237- 46. [Crossref]
  • 9. Gidley PW, Maw J, Gantz B, Kaylie D, Lambert P, Malekzadeh S, et al. Contemporary Opinions on Intraoperative Facial Nerve Monitoring. OTO Open 2018; 2: 2473974X18791803. [Crossref]
  • 10. Wilson L, Lin E, Lalwani A. Cost-effectiveness of intraoperative facial nerve monitoring in middle ear or mastoid surgery. Laryngoscope 2003; 113: 1736-45. [Crossref]
  • 11. Cochrane DD, Gustavsson B, Poskitt KP, Steinbok P, Kestle JR. The surgical and natural morbidity of aggressive resection for posterior fossa tumors in childhood. Pediatr Neurosurg 1994; 20: 19-29. [Crossref]
  • 12. Dubey A, Sung WS, Shaya M, Patwardhan R, Willis B, Smith D, et al. Complications of posterior cranial fossa surgery--an institutional experience of 500 patients. Surg Neurol 2009; 72: 369-75. [Crossref]
  • 13. Leonetti JP, Brackmann DE, Prass RL. Improved preservation of facial nerve function in the infratemporal approach to the skull base. Otolaryngol Head Neck Surg 1989; 101: 74-8. [Crossref]
  • 14. Niparko JK, Kileny PR, Kemink JL, Lee HM, Graham MD. Neurophysiologic intraoperative monitoring: II. Facial nerve function. Am J Otol 1989; 10: 55-61.
  • 15. Hammerschlag PE, Cohen NL. Intraoperative monitoring of facial nerve function in cerebellopontine angle surgery. Otolaryngol Head Neck Surg 1990; 103: 681-4. [Crossref]
APA KÜÇÜKYÜRÜK B, Taşkıran E (2021). Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. , 5 - 9.
Chicago KÜÇÜKYÜRÜK Barış,Taşkıran Emine Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. (2021): 5 - 9.
MLA KÜÇÜKYÜRÜK Barış,Taşkıran Emine Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. , 2021, ss.5 - 9.
AMA KÜÇÜKYÜRÜK B,Taşkıran E Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. . 2021; 5 - 9.
Vancouver KÜÇÜKYÜRÜK B,Taşkıran E Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. . 2021; 5 - 9.
IEEE KÜÇÜKYÜRÜK B,Taşkıran E "Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring." , ss.5 - 9, 2021.
ISNAD KÜÇÜKYÜRÜK, Barış - Taşkıran, Emine. "Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring". (2021), 5-9.
APA KÜÇÜKYÜRÜK B, Taşkıran E (2021). Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. Cerrahpaşa Medical Journal, 45(1), 5 - 9.
Chicago KÜÇÜKYÜRÜK Barış,Taşkıran Emine Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. Cerrahpaşa Medical Journal 45, no.1 (2021): 5 - 9.
MLA KÜÇÜKYÜRÜK Barış,Taşkıran Emine Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. Cerrahpaşa Medical Journal, vol.45, no.1, 2021, ss.5 - 9.
AMA KÜÇÜKYÜRÜK B,Taşkıran E Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. Cerrahpaşa Medical Journal. 2021; 45(1): 5 - 9.
Vancouver KÜÇÜKYÜRÜK B,Taşkıran E Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring. Cerrahpaşa Medical Journal. 2021; 45(1): 5 - 9.
IEEE KÜÇÜKYÜRÜK B,Taşkıran E "Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring." Cerrahpaşa Medical Journal, 45, ss.5 - 9, 2021.
ISNAD KÜÇÜKYÜRÜK, Barış - Taşkıran, Emine. "Comparison of Facial Nerve Function Outcomes in the Surgical Treatment of Cerebellopontine Angle Lesions with or without Intraoperative Neurophysiological Monitoring". Cerrahpaşa Medical Journal 45/1 (2021), 5-9.