Early Nerve Grafting for Facial Paralysis After Cerebellopontine Angle Tumor Resection With Preserved Facial Nerve Continuity

Object Facial nerve paresis can be a devastating complication following resection of large (> 2.5 cm) cerebellopontine angle (CPA) tumors. The authors have developed and used a new high-density diffusion tensor imaging (HD-DT imaging) method, aimed at preoperatively identifying the location and course of the facial nerve in relation to large CPA tumors. Their study objective was to preoperatively identify the facial nerve in patients with large CPA tumors and compare their HD-DT imaging method with a traditional standard DT imaging method and correlate with intraoperative findings. Methods The authors prospectively studied 5 patients with large (> 2.5 cm) CPA tumors. All patients underwent preoperative traditional standard- and HD-DT imaging. Imaging results were correlated with intraoperative findings. Results Utilizing their HD-DT imaging method, the authors positively identified the location and course of the facial nerve in all patients. In contrast, using a standard DT imaging method, the authors were unable to identify the facial nerve in 4 of the 5 patients. Conclusions The HD-DT imaging method that the authors describe and use has proven to be a powerful, accurate, and rapid method for preoperatively identifying the facial nerve in relation to large CPA tumors. Routine integration of HD-DT imaging in preoperative planning for CPA tumor resection could lead to improved facial nerve preservation.

Download Full-text

Long-term follow-up report on cross-facial nerve grafting in the treatment of facial paralysis

British Journal of Plastic Surgery ◽

10.1016/0007-1226(83)90009-7 ◽

1983 ◽

Vol 36 (1) ◽

pp. 48-50 ◽

Cited By ~ 7

Author(s):

Alain Gary-Bobo ◽

Jean Marc Fuentes

Keyword(s):

Facial Nerve ◽

Facial Paralysis ◽

Nerve Grafting ◽

Long Term Follow Up

Download Full-text

Retrosigmoid approach to cerebellopontine angle tumor resection: Surgical modifications

The Laryngoscope ◽

10.1002/lary.23524 ◽

2012 ◽

Vol 122 (11) ◽

pp. 2519-2523 ◽

Cited By ~ 8

Author(s):

Selena E. Heman-Ackah ◽

Maura K. Cosetti ◽

Sachin Gupta ◽

John G. Golfinos ◽

J. Thomas Roland

Keyword(s):

Cerebellopontine Angle ◽

Tumor Resection ◽

Retrosigmoid Approach ◽

Cerebellopontine Angle Tumor

Download Full-text

Masseter-to-Facial Cranial Nerve Anastomosis: A Report of 30 Cases

Operative Neurosurgery ◽

10.1093/ons/opaa140 ◽

2020 ◽

Vol 19 (5) ◽

pp. 502-509

Author(s):

Alexander V Zotov ◽

Jamil A Rzaev ◽

Sergey V Chernov ◽

Alexander B Dmitriev ◽

Anton V Kalinovsky ◽

...

Keyword(s):

Facial Nerve ◽

Cerebellopontine Angle ◽

Postoperative Recovery ◽

Facial Nerve Paralysis ◽

Tumor Surgery ◽

Nerve Function ◽

Facial Nerve Function ◽

Nerve Paralysis ◽

Cerebellopontine Angle Tumor ◽

Facial Reanimation

Abstract BACKGROUND Facial nerve paralysis (FP) is a possible complication of cerebellopontine angle tumor surgery. Several donor nerves have been used in the past for facial reanimation. We report the results of 30 cases of masseter-to-facial anastomosis. OBJECTIVE To prospectively evaluate the efficacy of V to VII anastomosis after FP. METHODS In a prospective study, we included 30 consecutive patients with FP (20 women and 10 men) whose mean age was 48.8 yr (32-76 yr). In almost all cases, FP developed after cerebellopontine angle tumor surgery (29 patients), whereas in one case, FP occurred after skull base trauma. Pre- and postoperative evaluation of facial nerve function was performed using the House-Brackmann (HB) scale and the Sokolovsky scale, as well as by electromyography. Follow-up ranged from 11 to 51 mo and averaged 22 mo. RESULTS All patients achieved functional recovery of the facial nerve from VI to either III or IV HB degree. Patients with short time FP showed significantly better postoperative recovery. CONCLUSION The results of the V to VII anastomosis demonstrate a significant improvement of facial nerve function and virtually no complications.

Download Full-text