Çмú´ëȸ ¹ßÇ¥ ¿¬Á¦ ÃÊ·Ï

¹ßÇ¥Çü½Ä : Á¢¼ö¹øÈ£ - 890347    OTOP-100 
The Analysis of Prognostic Factors for Postoperative Facial Palsy via Translabyrinthine Approac
Dept. of Otorhinolaryngology1, Inje Univ. College of Medicine, Ilsan Paik Hosp., Dept. of Otorhinolaryngology2, Sungkyunkwan Univ. Samsung Medical Center
Nam-Gyu RYU, Nam-Gyu RYU1, Yang-Sun CHO2
¸ñÀû: The tumors originated from internal auditory canal (IAC) or cerebellopotine angle (CPA) are rare, but the anatomic complexity of the skull base can cause various complications. In cases of any size tumors with non-serviceable hearing can be candidates of Translabyrinthine (TL) approaches. The aim of the study is to analyze the prognostic factors of postoperative facial nerve palsy (FNP) after TL approaches. ¹æ¹ý:Retrospective chart review was done from March 1997 to June 2014. The demographic data of patients and the size, location, origin, extent of tumor removal were described. Postoperative FNP was classified as House-Brackmann (H-B) grading and recurrence of the tumor were recorded both preoperatively and postoperatively (immediate, 1st, 3rd, 6th, 12th months, and the last status). We defined facial outcomes as good (H-B grade 1-2) and poor (H-B grade3). °á°ú:101 patients were included (MF=4358 mean age=50). The average size of tumors was 19.9mm, and the 31 cases were located intracanalicular 70 cases were extended to CPA. The demographic factor, origin, and location of tumors revealed no significant correlation with facial nerve outcome. As tumor size grows, facial nerve status showed worse outcome (p=0.03). Among the patients with postoperative FNP, better outcome achieved whose restoration of FNP started within 3 months (p=0.01) and cases of gross total removal (p=0.01). Patients with preoperative H-B grade 1 and 2 showed good facial outcome (p=0.03). However, neither delayed facial palsy nor recurrence of tumor showed significant changes (p>0.05). By multivariable analysis, good preoperative facial nerve status (H-B grad 1-2) was correlated with good postoperative faical nerve status. °á·Ð:The prognostic factors of facial palsy after TL approach operation were size, removal extent of tumor, the velocity of restoration of facial palsy and preoperative facial nerve status. However, both delayed facial palsy and recurrence of tumor influenced insignificantly.


[´Ý±â]