Functional Outcome of the Facial Nerve After Surgery for Vestibular Schwannoma: Prediction of Acceptable Long-Term Facial Nerve Function Based on Immediate Postoperative Facial Palsy

World Neurosurgery
Seunghoon LeeYang-Sun Cho

Abstract

To examine the relationship between immediate postoperative facial palsy and long-term facial palsy and identify a treatment strategy for vestibular schwannoma considering long-term outcomes of facial nerve function and tumor control. Patients (N = 385) who underwent surgery in a single institution were reviewed retrospectively; 12 patients with neurofibromatosis, 6 with preoperative radiosurgery, and 14 with multiple surgeries were excluded. The generalized estimating equation method was used to show the correlation between immediate and later postoperative facial palsy and to identify the cutoff grade of immediate postoperative facial palsy. The tumor control rates for 1 year, 3 years, and 5 years were 88.7%, 83.9%, and 80.0%. Preservation of facial function above House-Brackmann (H-B) grades 1 and 2 was achieved in 47.9% of patients immediately postoperatively, in 50.1% after 1 month, and in 74.5% after >2 years. The immediate postoperative facial palsy grade showed a statistically significant relationship with the facial palsy grade on long-term follow-up (P < 0.001). H-B grade 3 immediate postoperative facial palsy was identified as the cutoff grade that showed the most significant relationship between the grade of immedia...Continue Reading

References

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Citations

Jan 26, 2021·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Kareem O TawfikRoberto A Cueva

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