Abstract：
Abducens nerve (AN) schwannomas are extremely rare tumors. Clinical characteristics and factors that influence postoperative outcomes are not well defined.
To characterize clinical features of AN schwannomas and predictors of surgical outcomes.
PRISMA-guided systematic review of the literature on AN schwannomas was performed. Subsequently, univariate and multivariate regression analyses were performed to identify the predictive value of variables that influence postoperative outcomes.
A total of 42 studies with 55 patients were evaluated. The mean age at presentation was 43.9 ± 14.6 years. The most common presenting symptom was cranial nerve VI palsy (69.1%). Cavernous sinus (49.1%) and prepontine cistern (36.3%) were the most commonly involved locations. Complete recovery after surgery was seen in 36.3% at a median follow-up of 28.4 ± 25.8 months. Preoperative AN palsy (P < 0.001), suboccipital approach (P = 0.007), and subtotal resection of tumor (P = 0.044) were significant protective factors for postoperative complications. Prepontine location and postoperative complications were poor prognostic indicators of AN recovery (odds ratio [OR], 0.10, P = 0.030 and OR, 0.10, P = 0.028, respectively). Subtotal resection was significantly correlated with higher odds of AN recovery (OR, 6.06; P = 0.040).
AN schwannomas are rare but serious tumors that can cause significant morbidity, with only approximately one third of patients showing complete recovery after surgery. The suboccipital approach was a protective factor for postoperative complications, especially when combined with subtotal resection. Knowledge of these factors along with tumor characteristics helps optimize surgical planning and preoperative counseling.
To characterize clinical features of AN schwannomas and predictors of surgical outcomes.
PRISMA-guided systematic review of the literature on AN schwannomas was performed. Subsequently, univariate and multivariate regression analyses were performed to identify the predictive value of variables that influence postoperative outcomes.
A total of 42 studies with 55 patients were evaluated. The mean age at presentation was 43.9 ± 14.6 years. The most common presenting symptom was cranial nerve VI palsy (69.1%). Cavernous sinus (49.1%) and prepontine cistern (36.3%) were the most commonly involved locations. Complete recovery after surgery was seen in 36.3% at a median follow-up of 28.4 ± 25.8 months. Preoperative AN palsy (P < 0.001), suboccipital approach (P = 0.007), and subtotal resection of tumor (P = 0.044) were significant protective factors for postoperative complications. Prepontine location and postoperative complications were poor prognostic indicators of AN recovery (odds ratio [OR], 0.10, P = 0.030 and OR, 0.10, P = 0.028, respectively). Subtotal resection was significantly correlated with higher odds of AN recovery (OR, 6.06; P = 0.040).
AN schwannomas are rare but serious tumors that can cause significant morbidity, with only approximately one third of patients showing complete recovery after surgery. The suboccipital approach was a protective factor for postoperative complications, especially when combined with subtotal resection. Knowledge of these factors along with tumor characteristics helps optimize surgical planning and preoperative counseling.
摘要：
背景：外展神经（AN）神经鞘瘤是极其罕见的肿瘤。影响术后结局的临床特征和因素尚不明确。
目的：为了表征神经鞘瘤的临床特征和手术结果的预测因素方法和材料：对神经鞘瘤的文献进行PRISMA指导的系统综述。随后，我们进行了单因素和多因素回归分析,以确定影响术后结局的变量的预测值.
结果：共评估了42项包含55名患者的研究。演示时的平均年龄为43.9±14.6岁。最常见的症状是CNVI麻痹（69.1％）。海绵窦（49.1％）和脑前池（36.3％）是最常见的受累部位。在中位随访时间为28.4±25.8个月时，手术后完全恢复为36.3％。术前神经麻痹(P<0.001),枕下入路（P=0.007）和肿瘤次全切除术（P=0.044）是术后并发症的重要保护因素。前桥位置和术后并发症是AN恢复的不良预后指标（分别为OR0.10，P=0.030，OR0.10，P=0.028）。次全切除与较高的AN恢复几率显着相关(OR，6.06,P=0.040)。
结论：神经鞘瘤是罕见但严重的肿瘤，可引起显著的发病率，只有大约三分之一的患者在手术后显示完全康复。枕下入路是术后并发症的保护因素,尤其是与次全切除结合时。了解这些因素以及肿瘤特征有助于优化手术计划和术前咨询。
目的：为了表征神经鞘瘤的临床特征和手术结果的预测因素方法和材料：对神经鞘瘤的文献进行PRISMA指导的系统综述。随后，我们进行了单因素和多因素回归分析,以确定影响术后结局的变量的预测值.
结果：共评估了42项包含55名患者的研究。演示时的平均年龄为43.9±14.6岁。最常见的症状是CNVI麻痹（69.1％）。海绵窦（49.1％）和脑前池（36.3％）是最常见的受累部位。在中位随访时间为28.4±25.8个月时，手术后完全恢复为36.3％。术前神经麻痹(P<0.001),枕下入路（P=0.007）和肿瘤次全切除术（P=0.044）是术后并发症的重要保护因素。前桥位置和术后并发症是AN恢复的不良预后指标（分别为OR0.10，P=0.030，OR0.10，P=0.028）。次全切除与较高的AN恢复几率显着相关(OR，6.06,P=0.040)。
结论：神经鞘瘤是罕见但严重的肿瘤，可引起显著的发病率，只有大约三分之一的患者在手术后显示完全康复。枕下入路是术后并发症的保护因素,尤其是与次全切除结合时。了解这些因素以及肿瘤特征有助于优化手术计划和术前咨询。
