Interdisciplinary Neurosurgery (Dec 2022)
Facial nerve function and general outcome of patients operated for cerebellopontine angle tumors in Addis Ababa, Ethiopia, a retrospective study
Abstract
Introduction: Cerebellopontine angle (CPA) tumors consist of 10% of brain tumors. Surgical outcome is measured using functional status and cranial nerve preservation. Method: A hospital based retrospective cross-sectional descriptive study was done between August 31, 2015 and August 31, 2020. Fifty-five patients operated in the study period were enrolled in this study. Our study used House Brackmann Scale and Extended Glasgow Outcome Score. Fisher’s extract test was used to identify factors associated with outcome. P value < 0.05 was considered significant. Result: The mean age of the study participants was 36.64 years with male predominance (52.7%). Hearing loss (85%) was the commonest presentation. The mean tumor size was 4.4 cms ± 1.02. The tumors were operated through Retro-sigmoid approach without neurophysiologic monitoring. Post-operative CT scan shows GTR in 77.8%. At one year there were 66.7% patients with good facial nerve outcome, 20.8% with acceptable outcome and 12.5% with poor outcome. The post op GOS-E showed GOS-E of 8 in 25.5% and GOS-E of 7 in 23,6% of the patients. The operative mortality was high and predictors of mortality were postoperative infections (P =.003) and pre-operative facial palsy(P <.001) Conclusion: Our patients presented with larger tumor sizes. The rate of functional facial nerve preservation was low and the researchers advocate for improved microsurgical techniques and acquiring neuromonitoring to improve outcome. Health facilities evaluating the patients initially should have a systemic approach to diagnose the patients earlier and refer to a capable neurosurgical facility. The overall outcome was acceptable and surgery is a better option for the management of cerebellopontine angle tumors in our set-up.
