Experience of reinnervation of the facial muscles after removal of large and giant vestibular schwannomas
Abstract
Restoration of the mimic muscles is one of the most difficult problems in reconstructive surgery.
PURPOSE OF THE STUDY: to evaluate the results of facial nerve neurotization performed at various times after removal of large and giant vestibular schwannomas.
MATERIAL AND METHODS: The study analyzed the results of reinnervation of the facial nerve in patients after removal of large and giant vestibular schwannomas. On the 10–14th day after the removal of the tumor, reinnervation of the facial nerve was performed on 4 patients, in the long-term period from 6 to 12 months — on 17 patients.
RESULTS. The best results were obtained with direct trigeminal reinnervation of the facial nerve, carried out as early as possible. In these patients, it is possible to achieve the function of facial muscles corresponding to the House-Brackmann II–III. The worst results were noted among patients who underwent neurotization within 11–12 months after removal of vestibular schwannoma. The function of facial muscles in these patients was recovered only to House-Brackmann IV–VI.
CONCLUSION. Normalization of the function of facial muscles is one of the primary tasks in patients after removal of large and giant vestibular schwannomas. The results of our study indicate the greatest effectiveness of reinnervating surgeries performed as early as possible. The main problem of reinnervating operations performed by the XI and XII cranial nerves were violations of the function of muscles innervated by donor nerves.
About the Authors
P. G. Rudenko
Krasnoyarsk State Medical University named after professor V. F. Voyno-Yasenetsky of the Ministry of Health of Russia; KGBUZ «Krasnoyarsk Regional Clinical Hospital»
Russian Federation
Russian Federation
Rudenko Pavel Gennadievich
Krasnoyarsk
P. G. Shnyakin
Krasnoyarsk State Medical University named after professor V. F. Voyno-Yasenetsky of the Ministry of Health of Russia; KGBUZ «Krasnoyarsk Regional Clinical Hospital»
Russian Federation
Russian Federation
Shnyakin Pavel Gennadievich
Krasnoyarsk
V. P. Chumakov
KGBUZ «Krasnoyarsk Regional Clinical Hospital»
Russian Federation
Russian Federation
Chumakov Vladimir Pavlovich
Krasnoyarsk
A. V. Kanashin
KGBUZ «Krasnoyarsk Regional Clinical Hospital»
Russian Federation
Russian Federation
Kanashin Alexandr Vasilievich
Krasnoyarsk
A. A. Bashkov
Krasnoyarsk State Medical University named after professor V. F. Voyno-Yasenetsky of the Ministry of Health of Russia
Russian Federation
Russian Federation
Bashkov Arsenii Alexandrovich
Krasnoyarsk
References
1. Shimanskii V.N., Shevchenko K.V., Tanyashin S.V., Shul’gina A.A., Poshataev V.K., Odamanov D.A., Ka rnaukhov V.V. Posleoperatsionnye iskhody funktsii litsevogo nerva v zavisimosti ot topografii nevrinomy slukhovogo nerva. Sibirskoe meditsinskoe obozrenie. 2017; 6 (108): 104–109.(In russ.)
2. Shulev Yu.A., Trashin A. V., Rychkov V. l. Analiz nevrologicheskogo statusa i funktsional’nogo iskhoda posle neiroplastiki litsevogo nerva. Voprosy neirokhirurgii im. N. N. Burdenko. 2013;.77(2): 23–28.(In russ.)
3. Han J. H, Suh M. J., Kim j. W., Cho H. S., Moon I. S. Facial reanimation using hypoglossal-facial nerve anastomosis after schwannoma removal. acta otolaryngologica.2017;137(1):99105. doi.org/10.1080/00016489.2016.1212398.
4. Nechaeva A. S., Ulitin A. Yu., Pustovoi S. V., Tastanbekov M. M. Opyt reinnervatsii litsevogo nerva pod»yazychnym nervom dlya korrektsii posleoperatsionnoi disfunktsii litsevogo nerva. rossiiskii neirokhirurgicheskii zhurnal im. professora a. l. polenova. 2019; 11(3):32–37. (In russ.)
5. Makhmudov U. B., Cherekaev V.A., Shimanskii V. N., Tanyashin S. V., Belov A. I., Shelesko A.A. Plastika litsevogo nerva v khirurgii osnovaniya cherepa/ Khirurgiya opukholei osnovaniya cherepa. pod red. A. N. Konovalova. М. 2004; 360–371.(In russ.)
6. Halil A. K., Sanus G. Z., Ulu M. O., Tanriover N., Isler C., Tanriverdi T., Kafadar A. M. Hypoglossal-Facial Nerve anastomosis for Facial Nerve palsy Following Surgery for Vestibular Schwannoma: retrospective analysis of 13 patients. Turkish Neurosurgery. 2006; 16(4): 158–162
7. Nerobeev A. I., Visaitova Z. Yu., Somova M. M., Salikhov K. M. Porazheniya litsevogo nerva: o chem vrach dolzhen rasskazat’ patsientu. Vestnik esteticheskoi meditsiny, 2013; 12(4):12–20.(In russ.)
8. Zotov A.V., Rzaev D.A., Dmitriev A. B., Chernov S. V., Moisak G. I. Otsenka blizhaishikh rezul’tatov khirurgicheskogo lecheniya bol’nykh s litsevym paralichom metodom trigeminal’noi nevrotizatsii. Voprosy neirokhirurgii. 2016;4:31–39.(In russ.) doI: 10.17116/neiro201680431–39.
9. Joseph A. W., Kim J. C. Management of Flaccid Facial paralysis of less Than Two years’ duration. otolaryngologic Clinic. 2018;51:1093–1105. doI:10.1016/j.otc.2018.07.006.
10. Saidova Z. T.-A., ShtokAa. V., Tsyganov S. E., Dobrovol’skii G. F. Rekonstruktivnaya khirurgiya litsevogo nerva (poetapnoe modelirovanie tekhniki na trupnom materiale). Neirokhirurgiya 2020;22(2):49–57.(Inruss.) doI: 10.17650/1683-3295-2020-22-2-49-57
11. Nerobeev A. I., Kovanov A. V., Pol’shina V.I., Shirin A. A. Topografo-anatomicheskoe issledovanie dlya obosnovaniya tselesoobraznosti ispol’zovaniya zhevatel’nogo nerva v kachestve donora reinnervatsii pri disfunktsii mimicheskoi muskulatury. annaly plasticheskoi, rekonstruktivnoi i esteticheskoi khirurgii. 2014;1:15–19.(In russ.)
12. Zotov A. V., Chernov S. V., dmitriev A. B., Moisak G. I. Khirurgicheskoe lechenie paralicha litsevogo nerva. obzor literatury. rossiiskii neirokhirurgicheskii zhurnal imeni professora a. l. polenova. 2015.2015;2:78– 83(In russ.)
13. Henstrom D. K. Masseteric nerve use in facial reanimation // Current opinion otolaryngology and Head Neck Surgery.2014;22:284–290. doI:10.1097/Moo.0000000000000070.
14. Hontanilla B., Marre D., Cabello A. Masseteric nerve for reanimation of the smile in short-term facial paralysis. British journal of oral and Maxillofacial Surgery. 2014;52:118–123. doI:10.1016/j.bjoms.2013.09.017.
15. Tsymbalyuk Ya.V., Tsymbalyuk V. I., Tretyak I. B., Medvedev V. V., Gur’yanov V.G., Gatskii A.A., Petriv T. I. Sravnitel’nyi analiz razlichnykh vidov nevrotizatsii kak metoda khirurgicheskogo lecheniya perifericheskogo pareza litsevogo nerva. Novosti khirurgii. 2020; 28(3): 299–308.(In russ.)
16. Albathi M., Oyer S., Ishii L. E., Byrne P., Ishii M., Boahene K. O. Early Nerve grafting for Facial paralysis after Cerebellopontine angle Tumor resection with preserved Facial Nerve Continuity. JaMa Facial plast Surg. 2016;18(1):54–60. doI. org/10.1001/jamafacial.2015.1558.
Review
For citations:
Rudenko P.G., Shnyakin P.G., Chumakov V.P., Kanashin A.V., Bashkov A.A. Experience of reinnervation of the facial muscles after removal of large and giant vestibular schwannomas. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(2):139-144. (In Russ.)
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