Preservation of cranial nerve function following awake surgery for benign brain tumors in 22 consecutive patients

J Clin Neurosci. 2019 Mar:61:189-195. doi: 10.1016/j.jocn.2018.10.037. Epub 2018 Oct 26.

Abstract

Background: Preservation of cranial nerve function in patients with benign tumors such as meningiomas and vestibular schwannomas remains difficult following microsurgery.

Methods: In this study, awake surgery was performed in 22 consecutive patients with meningiomas or vestibular schwannomas that compressed cranial nerves (I-XII). Improved, unchanged, or deteriorated cranial nerve function after surgery was evaluated.

Results: The function of 44 cranial nerves in 22 consecutive patients who underwent awake surgery for meningiomas or vestibular schwannomas improved, was unchanged, or deteriorated in eight, 35, and one nerves, respectively. Regarding the function of the olfactory (Ist) nerve, which is difficult to preserve, hyposmia improved after surgery in two patients with olfactory groove meningiomas. Regarding the auditory (VIIIth) nerve, which is also difficult to preserve, the function was improved, unchanged, or deteriorated after surgery in two, 11, and one patients, respectively, with cerebello-pontine angle meningiomas or vestibular schwannomas. In all patients with serviceable auditory function before surgery, function was preserved after surgery. In the same patients, the function of the facial (VIIth) nerve was also preserved after surgery in all patients.

Conclusions: These results suggest that awake surgery for benign brain tumors such as meningiomas and vestibular schwannomas is associated with low patient morbidity regarding cranial nerve function.

Keywords: Auditory nerve; Awake surgery; Facial nerve; Meningioma; Olfactory nerve; Vestibular schwannoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / surgery*
  • Cranial Nerve Injuries / prevention & control
  • Cranial Nerves
  • Decompression, Surgical
  • Female
  • Humans
  • Male
  • Meningeal Neoplasms / surgery
  • Meningioma / surgery*
  • Middle Aged
  • Neuroma, Acoustic / surgery*
  • Neurosurgical Procedures / methods*
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Wakefulness*