An International Journal of Otorhinolaryngology Clinics

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VOLUME 3 , ISSUE 1 ( January-April, 2011 ) > List of Articles


Avoidance of Facial Nerve Injury in Lateral Skull Base Surgery

Michael E Sughrue

Keywords : Vestibular schwannoma,Acoustic neuroma,Microsurgery,Facial nerve

Citation Information : Sughrue ME. Avoidance of Facial Nerve Injury in Lateral Skull Base Surgery. Int J Otorhinolaryngol Clin 2011; 3 (1):65-70.

DOI: 10.5005/jp-journals-10003-1055

Published Online: 01-08-2011

Copyright Statement:  Copyright © 2011; The Author(s).


In the radiosurgery era, the treatment strategies for vestibular schwannoma have changed at most centers. This new paradigm holds that rational CPA tumor therapy requires balancing often competing goals of therapy, and the associated risks and benefits of different therapies or combination of therapies. The present review discusses this new paradigm and its specific implications for CPA tumor surgery. Inevitably, such a review will focus largely on minimizing facial nerve morbidity, as this is both the most modifiable risk, and the risk that is most reduced with the use of adjuvant therapies, such as stereotactic radiosurgery (like Gamma knife). The facts about facial nerve preservation in CPA tumor surgery will be reviewed, and methods for avoiding facial nerve morbidity will be discussed.

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  1. Some points in the surgery of the brain and its membranes. London: Mac Millian and Co. Ltd. 1907.
  2. Tumors of the nervus acusticus and the syndrome of the cerebellopontine angle. Philadelphia: London: WB Saunders 1917:296.
  3. Hearing preservation rates after microsurgical resection of vestibular schwannoma. J Clin Neurosci Sep 17(9):1126–29.
  4. Beyond audiofacial morbidity after vestibular schwannoma surgery. J Neurosurg 27 Nov, 2009.
  5. Preservation of facial nerve function after resection of vestibular schwannoma. Br J Neurosurg Dec 24(6):666–71.
  6. Non-audiofacial morbidity after gamma knife surgery for vestibular schwannoma. Neurosurg Focus Dec 2009;27(6):E4.
  7. Radiosurgery of vestibular schwannomas: Summary of experience in 829 cases. J Neurosurg Jan 2005;102(Suppl):195–99.
  8. Facial nerve preservation after vestibular schwannoma gamma knife radiosurgery. J Neurooncol May 2009;93(1):41–48.
  9. A prospective study of hearing preservation in untreated vestibular schwannomas. J Neurosurg May 21.
  10. Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys 1 Sep 2004;60(1):225–30.
  11. Extent of resection and the long-term durability of vestibular schwannoma surgery. J Neurosurg Jan 21.
  12. A critical evaluation of vestibular schwannoma surgery for patients younger than 40 years of age. Neurosurgery. Dec 67(6):1646–1653; Discussion 1653-44.
  13. Risk of malignancy after gamma knife stereotactic radiosurgery. Neurosurgery. Jan 2007;60(1):60–65; Discussion 65-66.
  14. The value of intraoperative facial nerve electromyography in predicting facial nerve function after vestibular schwannoma surgery. J Clin Neurosci; Jul 17(7):849–52.
  15. Intratumoral hemorrhage and fibrosis in vestibular schwannoma: A possible mechanism for hearing loss. J Neurosurg Jun 18.
  16. The natural history of untreated sporadic vestibular schwannomas: A comprehensive review of hearing outcomes. J Neurosurg 19 Jun, 2009.
  17. Molecular biology of familial and sporadic vestibular schwannomas: Implications for novel therapeutics. J Neurosurg 27 Nov, 2009.
  18. Implications of cystic features in vestibular schwannomas of patients undergoing microsurgical resection. Neurosurgery 6 Jan.
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