Multivariate analysis of factors influencing postoperative facial nerve function after vestibular schwannoma surgery

Abstract

Objective To investigate the risk factors of vestibular schwannoma without facial nerve functional preservation. Methods Total 95 patients with vestibular schwannoma who underwent surgery via the sigmoid sinus approach bewteen December 2018 to January 2020 were included. Tumor diameter and classification, tumor volume and surface area, tumor property were recorded according to MRI. The course of facial nerve, adhesion degree between tumor and facial nerve, extent of tumor resection and facial nerve anatomic preservation were recorded according to intraoperative observation. Facial nerve function after 8 d was evaluated. Univariate and multivariate Logistic regression analyses were performed to analyze risk factors associated without facial nerve functional preservation. Results Of the 95 patients, 80 patients (84.21%) underwent gross total resection, among which 3 patients had no anatomical preservation of facial nerve. 15 patients (15.79%) underwent near total resection, including 14 cases with thin layer of tumor remaining on the facial nerve, and one case with thin layer of tumor remaining on the brainstem and no anatomical preservation of facial nerve. Logistic regression analysis showed that severe adhesion between tumor and facial nerve was risk factor for functional impairment of facial nerve (OR = 22.349, 95%CI: 1.895-263.599; P = 0.014). Conclusions For severe adhesion, the operation should be more careful. If the tumor might not be completely removed under the premise of preserving the facial nerve function, a small amount of tumor could be left on the facial nerve.

Keywords

• neurilemmoma
• vestibular nerve
• facial nerve injuries
• microsurgery
• risk factors
• logistic models