Nervus intermedius dysfunctions after vestibular schwannoma surgery: a prospective clinical study
| Autor: | Katja Kniese, Hussam Metwali, Madjid Samii, Babak Kardavani, Venelin Gerganov |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Taste medicine.medical_specialty Schwannoma Taste sensation Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Prospective Studies 030223 otorhinolaryngology Prospective cohort study Vestibular system business.industry Neuroma Acoustic General Medicine Middle Aged medicine.disease Cerebellopontine angle Facial nerve Surgery Facial Nerve Prospective clinical study Female business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Neurosurgery. 131:555-560 |
| ISSN: | 1933-0693 0022-3085 |
| Popis: | OBJECTIVEThe purpose of this prospective study was to evaluate the dysfunction of the nervus intermedius (NI) after vestibular schwannoma (VS) surgery. The authors present a clinically feasible method for this purpose.METHODSIn this prospective study, the authors included 30 patients who underwent surgery at the International Neuroscience Institute between May 2014 and February 2017 for resection of VS. The patients’ taste sensation was examined using taste strips. Lacrimation was tested using the Schirmer I test. The clinical evaluation was performed before surgery and repeated at 2 weeks and at 6 months after surgery as well as during the follow-up, which extended up to 2 years. The authors tested the correlation between the NI dysfunctions and the House-Brackmann grade of facial nerve palsy.RESULTSThe taste sensation was lost on the side of surgery in 2 patients (6.6%) and decreased in 4 patients (13.3%). The disturbance of taste sensation was not statistically correlated with dysfunctions of the motor portion of the facial nerve. The taste impairment resolved in 4 patients within 6 months, but 2 patients suffered from persistent loss of the taste sensation on the side of surgery during the follow-up. In 23 patients (76.6%), the baseline lacrimation was lower on the side of surgery, and it was significantly correlated with outcome for dysfunctions of the motor portion of the facial nerve. During the follow-up, baseline lacrimation improved in correlation with the improvement in the dysfunctions of the motor portion of the facial nerve. None of the patients reported change in salivation or nasal secretion.CONCLUSIONSThe NI can be affected after VS surgery. The disturbance of baseline lacrimal secretion was correlated with dysfunctions of the motor portion of the facial nerve. However, the disturbance of the taste sensation was not correlated with the grade of facial nerve palsy. Dysfunctions of the NI should be evaluated and separately reported while analyzing facial nerve outcome after VS surgery. |
| Databáze: | OpenAIRE |
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