Surgical management of large lower cranial nerves schwannomas: long term results of a less aggressive resection strategy.

Autor: Troude L; Department of Neurosurgery, North University Hospital, APHM-AMU Chemin Des Bourrely, 13015, Marseille, France. lucas.troude@ap-hm.fr., Ogando YE; Department of Neurosurgery, North University Hospital, APHM-AMU Chemin Des Bourrely, 13015, Marseille, France., Balossier A; Department of Neurosurgery, Timone University Hospital, APHM-AMU - 264 Rue Saint-Pierre, 13385, Marseille, France., Baucher G; Department of Neurosurgery, North University Hospital, APHM-AMU Chemin Des Bourrely, 13015, Marseille, France., Régis J; Department of Neurosurgery, Timone University Hospital, APHM-AMU - 264 Rue Saint-Pierre, 13385, Marseille, France., Roche PH; Department of Neurosurgery, North University Hospital, APHM-AMU Chemin Des Bourrely, 13015, Marseille, France.
Jazyk: angličtina
Zdroj: Neurosurgical review [Neurosurg Rev] 2024 Apr 19; Vol. 47 (1), pp. 171. Date of Electronic Publication: 2024 Apr 19.
DOI: 10.1007/s10143-024-02416-x
Abstrakt: In an effort to reduce the high morbidity and life-threatening complications after radical resection in large schwannoma surgery, alternative strategies of nontotal resections have emerged. To evaluate the long term clinical and oncological outcome after lower cranial nerves (LCN) schwannoma surgery operated on with a cranial nerve-sparing technique. Single center retrospective cohort study of 8 consecutive patients harboring LCN schwannomas operated on between March 2005 and October 2021. The mean LCN schwannoma diameter was 33 mm (range 26-51). Seven patients (87,5%) underwent a modified retrosigmoid approach. Three patients underwent gross total resection (37,5%), 3 had received neartotal resection (mean tumor residue 0,25 cc) and subtotal resection in 2 patients who presented with an extracranial extension of the tumor (mean tumor residue 2,44 cc). Both patients had received upfront additional GKRS. The three patients who presented with preoperative CN IX & X injuries recovered within 6 months after surgery. All of the five patients freed from any preoperative CNs IX & X symptoms experienced transient (80%) or definitive (one patient) disturbances after surgery. They all improved within 6 months but one who required long term gastrostomy feeding tube. This patient harbored a schwannoma originating from the glossopharyngeal nerve, which could not be anatomically preserved during surgery. Tumor control was achieved in 100% of cases with a mean follow-up of 91 months. LCN schwannomas could be surgically removed through a less aggressive non-radical resection strategy with acceptable functional results and excellent tumor control.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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