Outcomes after semisitting and lateral positioning in large vestibular schwannoma surgery : A single-center comparison
Copyright © 2021 Elsevier B.V. All rights reserved..
OBJECTIVE: The semisitting position (SSP) and lateral position (LP) in vestibular schwannoma (VS) surgery each have advantages and disadvantages, and which position is superior overall is debatable. Our objective was to determine the optimal position for surgical treatment of VSs with a diameter ≥3 cm.
METHODS: We retrospectively evaluated consecutive patients with a large VS treated between January 2010 and July 2020. Patients were grouped by surgical position and analyzed.
RESULTS: We enrolled 259 patients (LP group, n = 156; SSP group, n = 103). The resection extent was not significantly different between the SSP (gross-total resection [GTR], n = 89 [88.1%], near-total resection [NTR], n = 10 [9.9%], subtotal resection [STR], n = 2 [2.0%]) and LP (GTR, n = 125 [80.1%]; NTR, n = 24 [15.4%]; STR, n = 7 [4.5%]) groups. The rate of GTR with facial nerve (FN) functional preservation was higher in the SSP group than in the LP group (P = 0.014) at eight days after the operation. However, during follow-up (SSP group median, 31.5 months; LP group median, 19.5 months), there was no significant between-group difference in FN functional preservation. Two patients in the SSP group required conversion to the LP due to severe intraoperative venous air embolism (VAE).
CONCLUSION: Compared with the LP, the SSP did not produce significantly better FN outcomes in patients with a large VS. The duration of surgery was significantly longer in SSP cases than in LP cases. Given the risk of VAE associated with the SSP, the selection of the optimal surgical position should be made with caution on an individual basis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:207 |
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| Enthalten in: |
Clinical neurology and neurosurgery - 207(2021) vom: 30. Aug., Seite 106768 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Song, Gang [VerfasserIn] |
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| Links: |
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| Themen: |
Comparative Study |
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| Anmerkungen: |
Date Completed 25.01.2022 Date Revised 25.01.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.clineuro.2021.106768 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327227184 |
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| 100 | 1 | |a Song, Gang |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes after semisitting and lateral positioning in large vestibular schwannoma surgery |b A single-center comparison |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 25.01.2022 | ||
| 500 | |a Date Revised 25.01.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVE: The semisitting position (SSP) and lateral position (LP) in vestibular schwannoma (VS) surgery each have advantages and disadvantages, and which position is superior overall is debatable. Our objective was to determine the optimal position for surgical treatment of VSs with a diameter ≥3 cm | ||
| 520 | |a METHODS: We retrospectively evaluated consecutive patients with a large VS treated between January 2010 and July 2020. Patients were grouped by surgical position and analyzed | ||
| 520 | |a RESULTS: We enrolled 259 patients (LP group, n = 156; SSP group, n = 103). The resection extent was not significantly different between the SSP (gross-total resection [GTR], n = 89 [88.1%], near-total resection [NTR], n = 10 [9.9%], subtotal resection [STR], n = 2 [2.0%]) and LP (GTR, n = 125 [80.1%]; NTR, n = 24 [15.4%]; STR, n = 7 [4.5%]) groups. The rate of GTR with facial nerve (FN) functional preservation was higher in the SSP group than in the LP group (P = 0.014) at eight days after the operation. However, during follow-up (SSP group median, 31.5 months; LP group median, 19.5 months), there was no significant between-group difference in FN functional preservation. Two patients in the SSP group required conversion to the LP due to severe intraoperative venous air embolism (VAE) | ||
| 520 | |a CONCLUSION: Compared with the LP, the SSP did not produce significantly better FN outcomes in patients with a large VS. The duration of surgery was significantly longer in SSP cases than in LP cases. Given the risk of VAE associated with the SSP, the selection of the optimal surgical position should be made with caution on an individual basis | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Facial nerve | |
| 650 | 4 | |a Lateral position | |
| 650 | 4 | |a Semisitting position | |
| 650 | 4 | |a Vestibular schwannoma | |
| 700 | 1 | |a Liu, Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Xiaolong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xu |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Yiqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Mingchu |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Qingtang |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Hongchuan |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Jie |e verfasserin |4 aut | |
| 700 | 1 | |a Xiao, Xinru |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ge |e verfasserin |4 aut | |
| 700 | 1 | |a Bao, Yuhai |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Jiantao |e verfasserin |4 aut | |
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