Subject(s)
Carcinoma, Squamous Cell/prevention & control , Mouth Neoplasms/prevention & control , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/therapy , Humans , Incidence , Mouth Neoplasms/diagnosis , Mouth Neoplasms/epidemiology , Mouth Neoplasms/therapy , New Zealand/epidemiology , RegistriesABSTRACT
BACKGROUND: Between January 1988 and December 2002, 97 patients underwent surgery for excision of vestibular schwannoma via the retrosigmoid approach at Christchurch Hospital. METHODS: A retrospective review was undertaken of the clinical notes with emphasis on facial nerve function and hearing preservation postoperatively. RESULTS: Of patients with small and medium-sized tumours, 81% had good facial nerve function at 1 year (House-Brackmann grade 1 and grade 2), 16% had moderate function (grade 3 and grade 4) and 3% had poor function (grade 5). Of patients with large tumours, 22% had good facial function (grade 1 and grade 2), 37% had moderate function (grade 3 and grade 4) and 41% had poor function (grade 5 and grade 6). Useful postoperative hearing was preserved in 21% of the 47 patients with tumours <3 cm and useful preoperative hearing. In the last 5 years the authors have been operating in conjunction with an ear, nose and throat surgeon (PAB) trained in base-of-skull surgery. Over this period, useful hearing was preserved in 32% of patients with small and medium-sized tumours and useful preoperative hearing. CONCLUSIONS: Tumour size was an important predictor of the postoperative facial and cochlear nerve function. The multidisciplinary approach to these tumours offers better results. These results compare well with other published series.
Subject(s)
Facial Nerve/physiology , Hearing/physiology , Neuroma, Acoustic/surgery , Adolescent , Adult , Auditory Threshold , Female , Hearing Loss/etiology , Humans , Male , Neoplasm Recurrence, Local , Neurofibromatosis 2/surgery , Neuroma, Acoustic/complications , Neuroma, Acoustic/diagnosis , Neuroma, Acoustic/mortality , Postoperative Complications , Retrospective Studies , Time Factors , Tinnitus/etiology , Treatment Outcome , Vertigo/etiologyABSTRACT
AIMS: To review patients admitted with head injuries under a regional neurosurgical service, to document the incidence and features of associated maxillofacial trauma, and to assess any delay in referral to a maxillofacial surgeon for definitive management of facial injuries. METHODS: The details of all patients admitted under the neurosurgical service at Christchurch Hospital over the preceding 7 years (1995-2002) were reviewed via that department's database. The records of those patients noted to have a maxillofacial injury were requested, and the following data obtained: demographics, diagnosis, and mode of injury (including specific variables such as alcohol consumption and seatbelt usage in motor vehicle accidents). RESULTS: 2307 patients were admitted under the neurosurgical service at Christchurch Hospital over a 7-year period. Five percent of those patients had an associated maxillofacial injury. Three-quarters were men, with an average age of 27 years. Motor vehicle accidents and assaults were the most common cause of injury. Nearly one-third of those persons in motor vehicle accidents were not wearing seatbelts. Alcohol was more frequently involved in mild and moderate head injuries and these patients were more likely to have been assaulted than those admitted with severe head injuries. There were no significant delays in referring patients admitted who had an associated maxillofacial injury to a maxillofacial surgeon. CONCLUSIONS: A small but significant number of patients admitted with head injuries will have an associated maxillofacial injury.
