Facial nerve outcome with a Peroperative stimulation threshold under 0.05 mA §

Authors

  • Patrick Marin MD,

    Corresponding author
    1. Otolaryngology and Head and Neck Surgery department, Centre Hospitalier Affilié Universitaire de Québec, Pavillon l'Enfant-Jésus, Laval University, Quebec City, Canada
    • Hôpital Enfant-Jésus, 1401, 18e rue, Quebec, G1J 1Z4 Canada
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  • Denis Pouliot MD, FRCS(C),

    1. Otolaryngology and Head and Neck Surgery department, Centre Hospitalier Affilié Universitaire de Québec, Pavillon l'Enfant-Jésus, Laval University, Quebec City, Canada
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  • Gaétan Fradet MD, FRCS(C)

    1. Otolaryngology and Head and Neck Surgery department, Centre Hospitalier Affilié Universitaire de Québec, Pavillon l'Enfant-Jésus, Laval University, Quebec City, Canada
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  • Editor's Note: This Manuscript was accepted for publication July 21, 2011.

  • Presented as a poster at the 64th Annual Meeting of the Canadian Society of Otolaryngology–Head and Neck Surgery, Niagara Falls, Ontario, Canada, May 23–25, 2010.

  • §

    The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To evaluate the facial nerve outcome postoperatively of schwannoma vestibular surgery with a stimulation threshold (ST) lower than 0.05 mA.

Study Design:

Retrospective chart review.

Methods:

A total of 106 patients had undergone schwannoma vestibular surgery between 2002 and 2008 in a tertiary center. The ST near the brainstem was obtained after the tumor removal. Facial nerve function was evaluated according to the House-Brackmann (HB) scale immediately postoperatively and at 1 year. The results were compared among the different STs used: <0.05 mA, 0.05 mA, and >0.05 mA.

Results:

There were 50 patients who had an ST <0.05 mA, 45 patients who had an ST of 0.05 mA, and 11 patients who had a ST >0.05 mA. Immediately postoperatively, for all of these groups we had a preservation of facial nerve function (HB I-II) in 94%, 80%, and 36% of patients, respectively (P < .0001). At 1 year in the same groups the preservation of the facial nerve function was 100%, 93%, and 82% of patients, respectively (P < .01).

Conclusions:

A proximal ST of <0.05 mA is a better predictor of facial nerve function immediately postoperatively. Laryngoscope, 121:2295–2298, 2011

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