Abstract
Introduction: Vestibular schwannoma (VS) is a slow-growing, benign tumor that is usually diagnosed when symptoms develop. Surgical management aims to reduce long-term sequelae (LTS) associated with late diagnosis.
Objective: Identify predictive factors of LTS after VS surgery and clinical outcome measured by modified Rankin scale (mRS).
Methods: This cohort study included patients submitted to VS surgery from 1999 to 2014, with a mean follow-up of 6.4 ± 4.5 years. Disability was assessed across the mRS the primary outcome was defined by scores 3 to 6, which implied poor outcome in neurological recovery. Predictive factors were identified through multivariate logistic regression.
Results: A total of 101 patients were included in this study. Fifty-one (50.49%) presented mRS ≥ 3 on the late postoperative period. Men comprise 22.8%, and the mean age was 47.1 ± 16.0 years (range19–80). Patients with mRS ≥ 3 presented larger tumors (3.7 ± 1.1 cm vs. 3.2 ± 1.0 cm, p < .001), less total resection (50% vs. 76.7%, p < .010) and more neurofibromatosis II(NFII) (84.9% vs. 64.3%, p = .023). On multivariate analysis NFII, tumor size and type resection were predictive of degree of autonomy (mRS ≥3: NF II (OR 3.5, 95% CI 1.08–11.36, p = .036) and tumor size (each 1 cm, OR1.51, 95% CI 0.96–2.38, p = .050).
Conclusion: Tumor size, presence of NFT II, type of surgical approach and number of surgeries were identified as predictive factors of functional sequelae in long-term follow-up after VS surgery.
- Highlights
- One-third of our patients presented some degree of disability that impact in autonomy (mRS ≥ 3) in the late postoperative period.
- Tumor size, NFII, surgical approach were predictive to comprise independency.
- Considering the cranial nerve monitoring and late diagnosis, our results can give some contribution to understanding the Brazilian profile of VS surgery.
- Our findings suggests the need to look over what it is well recognized and identify aspects that affect the prognosis such as functional disabilities in VS surgery.
