Outcomes of Continuos Dissection Technique with Monopolar Probe in Cerebellopontine Angle Tumor Resection

Abstract

Background: Cerebellopontine angle tumor (CP angle tumor) is the common skull base tumor and the surgical outcomes are vary between institution. Facial nerve palsy is the most important morbidity with incidence rate of 63-94% which is the condiction of disability. Recently, the new continuous and dynamic stimulation technique is used to identify facial nerve during surgical resection. This study describes the new technique as the continuous dissection technique with the monopolar probe, which is limited documents in literature.Objective: To describe the facial nerve outcomes, the degree of resection, workflow, and the safety of the new technique with monopolar probe.Methods: A cross-sectional study was conducted between 2017 and 2018. Medical records and the data of twenty-one patients who had the CP angle tumor performing the continuous mapping dissection technique with the monopolar probe was retrospectively collected and analysed. Age, sex, pre and post-operative facial nerve function, pre and post-operative tumor size, and complications were collected. The categorical data and continuous data outcomes between before and after surgery were compared using Fishers’ exact test and Wilcoxon signed rank test. The ethics committee, Rajavithi hospital, reviewed and approved this study.Results: The female was predominant, and the mean age was 54.38±12.52 years. The most common tumor was acoustic neuroma (90.5%), and the mean operative time was 4.28±1.69 hrs. The median size of post operative tumor was significantly smaller than that of preoperative tumor (p<0.001: 0.50 vs 3.28 cm). The preoperative facial nerve function was not different before and after surgery. Only one patient had a complication (4.8%), and total tumor removal was done in seven patients.Conclusion: The monopolar probe’s continuous dissection technique is a safe technique with good workflow and good outcomes compared with standard procedure.