Facial nerve injury in acoustic neuroma (vestibular schwannoma) surgery: Etiology and prevention

1998 ◽  
Vol 56 (2) ◽  
pp. 277-278
Author(s):  
Roger E Alexander
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Vestibular Schwannoma ◽  
Acoustic Neuroma ◽  
Facial Nerve Injury

scholarly journals Facial nerve elongation as predictive factors of facial nerve outcome after the vestibular schwannoma resection

2021 ◽  
Author(s):  
Zhi Zhu ◽  
Weichao Jiang ◽  
Xi Chen ◽  
Sifang Chen ◽  
Guowei Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Logistic Regression Analysis ◽  
Vestibular Schwannoma ◽  
Functional Outcomes ◽  
Tumor Volume ◽  
Facial Nerve Injury

Abstract Background: To analyze risk factors affecting the long-term facial nerve functional outcomes in patients receiving vestibular schwannoma surgery. Method: A total of 89 cases receiving vestibular schwannoma surgery via retrosigmoid sinus approach were analyzed retrospectively. The facial nerve functional outcomes of all enrolled patients were evaluated 6 months after the operation according to House-Brackmann grading scale. The relationships between facial nerve injury and its potential risk factors were analyzed. Results: Postoperative facial nerve injury was found in 53 patients (59.6%) 6 months after the operation. The results of univariate logistic regression analysis indicated that the tumor volume, the maximum tumor diameter, the facial nerve elongation, the enlargement of internal auditory canal (IAC), the IAC size on the affected side, and the facial nerve adhesion to tumor were significantly correlated with the occurrence of facial nerve injury. The multivariate logistic regression analysis revealed that the facial nerve elongation, the facial nerve adhesion to tumor, the tumor volume, and the enlargement of IAC were the independent risk factors of facial nerve injury 6 months after vestibular schwannoma surgery. The ROC curve showed that the cut-off points of the facial nerve elongation, tumor volume and enlargement of IAC were 2.925cm,10.965 cm³ and 1.818 respectively. When the cut-off points were exceeded, the possibility of facial nerve injury would largely increase. Conclusion: With the growth of the facial nerve elongation, the tumor volume, the facial nerve adhesion to tumor, and the enlargement of IAC, the possibility of facial nerve injury after the vestibular schwannoma surgery would accordingly increase.

Neuroanatomical correlation of the House-Brackmann grading system in the microsurgical treatment of vestibular schwannoma

2012 ◽  
Vol 33 (3) ◽  
pp. E7 ◽  
Author(s):  
Matthew Z. Sun ◽  
Michael C. Oh ◽  
Michael Safaee ◽  
Gurvinder Kaur ◽  
Andrew T. Parsa
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Vestibular Schwannoma ◽  
Grading System ◽  
Psychological Consequences ◽  
Factors Affecting ◽  
Functional Deficits ◽  
Facial Nerve Injury ◽  
Ability To Regenerate ◽  
Nerve Recovery

Avoidance of facial nerve injury is one of the major goals of vestibular schwannoma (VS) surgery because functional deficits of the facial nerve can lead to physical, cosmetic, and psychological consequences for patients. Clinically, facial nerve function is assessed using the House-Brackmann grading scale, which also allows physicians to track the progress of a patient's facial nerve recovery. Because the facial nerve is a peripheral nerve, it has the ability to regenerate, and the extent of its functional recovery depends largely on the location and nature of its injury. In this report, the authors first describe the facial nerve anatomy, the House-Brackmann grading system, and factors known to be predictors of postoperative facial nerve outcome. The mechanisms and pathophysiology of facial nerve injury during VS surgery are then discussed, as well as factors affecting facial nerve regeneration after surgery.

Facial nerve injury in acoustic neuroma (vestibular schwannoma) surgery: etiology and prevention

1997 ◽  
Vol 87 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Prakash Sampath ◽  
Michael J. Holliday ◽  
Henry Brem ◽  
John K. Niparko ◽  
Donlin M. Long
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Acoustic Neuroma ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Content Type ◽  
Facial Nerve Injury ◽  
Acoustic Neuroma Surgery ◽  
Fine Print

✓ Facial nerve injury associated with acoustic neuroma surgery has declined in incidence but remains a clinical concern. A retrospective analysis of 611 patients surgically treated for acoustic neuroma between 1973 and 1994 was undertaken to understand patterns of facial nerve injury more clearly and to identify factors that influence facial nerve outcome. Anatomical preservation of the facial nerve was achieved in 596 patients (97.5%). In the immediate postoperative period, 62.1% of patients displayed normal or near-normal facial nerve function (House—Brackmann Grade 1 or 2). This number rose to 85.3% of patients at 6 months after surgery and by 1 year, 89.7% of patients who had undergone acoustic neuroma surgery demonstrated normal or near-normal facial nerve function. The surgical approach appeared to have no effect on the incidence of facial nerve injury. Poor facial nerve outcome (House—Brackmann Grade 5 or 6) was seen in 1.58% of patients treated via the suboccipital approach and in 2.6% of patients treated via the translabyrinthine approach. When facial nerve outcome was examined with respect to tumor size, there clearly was an increased incidence of facial nerve palsy seen in the immediate postoperative period in cases of larger tumors: 60.8% of patients with tumors smaller than 2.5 cm had normal facial nerve function, whereas only 37.5% of patients with tumors larger than 4 cm had normal function. This difference was less pronounced, however, 6 months after surgery, when 92.1% of patients with tumors smaller than 2.5 cm had normal or near normal facial function, versus 75% of patients with tumors larger than 4 cm. The etiology of facial nerve injury is discussed with emphasis on the pathophysiology of facial nerve palsy. In addition, on the basis of the authors' experience with these complex tumors, techniques of preventing facial nerve injury are discussed.

Facial nerve injury in acoustic neuroma (vestibular schwannoma) surgery: etiology and prevention

1998 ◽  
Vol 5 (3) ◽  
pp. E8 ◽  
Author(s):  
Prakash Sampath ◽  
Michael J. Holliday ◽  
Henry Brem ◽  
John K. Niparko ◽  
Donlin M. Long
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Acoustic Neuroma ◽  
Postoperative Period ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Nerve Injury ◽  
Acoustic Neuroma Surgery

Facial nerve injury associated with acoustic neuroma surgery has declined in incidence but remains a clinical concern. A retrospective analysis of 611 patients surgically treated for acoustic neuroma between 1973 and 1994 was undertaken to understand patterns of facial nerve injury more clearly and to identify factors that influence facial nerve outcome. Anatomical preservation of the facial nerve was achieved in 596 patients (97.5%). In the immediate postoperative period, 62.1% of patients displayed normal or near-normal facial nerve function (House-Brackmann Grade 1 or 2). This number rose to 85.3% of patients at 6 months after surgery and by 1 year, 89.7% of patients who had undergone acoustic neuroma surgery demonstrated normal or near-normal facial nerve function. The surgical approach appeared to have no effect on the incidence of facial nerve injury. Poor facial nerve outcome (House-Brackmann Grade 5 or 6) was seen in 1.58% of patients treated via the suboccipital approach and in 2.6% of patients treated via the translabyrinthine approach. When facial nerve outcome was examined with respect to tumor size, there clearly was an increased incidence of facial nerve palsy seen in the immediate postoperative period in cases of larger tumors: 60.8% of patients with tumors smaller than 2.5 cm had normal facial nerve function, whereas only 37.5% of patients with tumors larger than 4 cm had normal function. This difference was less pronounced, however, 6 months after surgery, when 92.1% of patients with tumors smaller than 2.5 cm had normal or near normal facial function, versus 75% of patients with tumors larger than 4 cm. The etiology of facial nerve injury is discussed with emphasis on the pathophysiology of facial nerve palsy. In addition, on the basis of the authors' experience with these complex tumors, techniques of preventing facial nerve injury are discussed.

Case Report: Facial Nerve Bifurcation Noted During Resection of Vestibular Schwannoma

2018 ◽  
Vol 15 (4) ◽  
pp. 36-39 ◽  
Author(s):  
Jennifer D Sokolowski ◽  
Douglas S Ruhl ◽  
Bradley W Kesser ◽  
Ashok R Asthagiri
Keyword(s):  
At Risk ◽  
Case Report ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Vestibular Schwannoma ◽  
Cerebellopontine Angle ◽  
Clinical Presentation ◽  
Anatomic Variations ◽  
Facial Nerve Injury ◽  
Facial Nerve Anatomy

Abstract BACKGROUND AND IMPORTANCE Resection of cerebellopontine angle tumors is challenging because the proximity of the facial nerve puts it at risk of inadvertent injury and subsequent dysfunction. It is critical to consider variations in anatomy and be aware of the potential deviations in the course of the nerve in order to avoid damage. CLINICAL PRESENTATION We present a case of a facial nerve bifurcation identified during resection of a vestibular schwannoma. CONCLUSION This is the only reported case of proximal facial nerve bifurcation. We review what is known about variations in proximal facial nerve anatomy, the rates of facial nerve injury after schwannoma resection, and the importance of neuromonitoring in identifying the nerve and predicting function postoperatively. Ultimately, understanding possible anatomic variations in the nerve is critical to minimize iatrogenic injury during surgery.

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