Evaluation of VIIth–XIIth cranial nerve anastomosis results by age

2020 ◽  
Vol 134 (2) ◽  
pp. 165-168
Author(s):  
F C Eravcı ◽  
F Karaloğlu ◽  
H Tutar ◽  
F K Bakkal ◽  
V B Tutar ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Cranial Nerve ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Movement ◽  
Significant Difference ◽  
Nerve Anastomosis ◽  
Grade Iii

AbstractObjectiveTo evaluate VIIth–XIIth cranial nerve (hypoglossal–facial nerve) anastomosis results by age.MethodA total of 34 patients who attended a follow-up visit in 2016, aged 20–63 years, were enrolled. The House–Brackmann facial nerve function grading system and the Facial Clinimetric Evaluation scale were applied.ResultsRegarding post-anastomosis facial nerve function, in the group aged 40 years or less, 14 patients (78 per cent) had House–Brackmann grade III and 4 patients (22 per cent) had House–Brackmann grade IV facial nerve function post-anastomosis. In the group aged over 40 years, nine patients (56 per cent) had House–Brackmann grade III and seven patients (44 per cent) had House–Brackmann grade IV facial nerve function post-anastomosis. There was a statistically significant difference between the two groups in mean facial movement domain scores (p = 0.02). Analysis between age and facial movement score in all 34 patients demonstrated a moderate negative correlation (Pearson correlation coefficient: −0.38) and statistical significance (p = 0.02).ConclusionFacial reanimation yielded better results in younger than in older patients.

Hypoglossal-Facial Nerve Anastomosis: A Meta-Analytic Study

2007 ◽  
Vol 116 (7) ◽  
pp. 542-549 ◽  
Author(s):  
Sertac Yetiser ◽  
Ugur Karapinar
Keyword(s):  
Facial Nerve ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cranial Nerves ◽  
Facial Nerve Paralysis ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Reliable Technique ◽  
Nerve Paralysis ◽  
Nerve Anastomosis

Objectives: A meta-analysis was conducted on the outcome of facial nerve function after hypoglossal-facial nerve anastomosis in humans. The roles of the timing of and the underlying cause for surgery, the type of the repair, and previous facial nerve function in the final result were analyzed. Methods: Articles were identified by means of a PubMed search using the key words “facial-hypoglossal anastomosis,” which yielded 109 articles. The data were pooled from existing literature written in English or French. Twenty-three articles were included in the study after we excluded those that were technical reports, those describing anastomosis to cranial nerves other than the hypoglossal, and those that were experimental animal studies. Articles that reported facial nerve function after surgery and timing of repair were included. Facial nerve function had to be reported according to the House-Brackmann scale. If there was more than 1 article by the same author(s), only the most recent article and those that did not overlap and that matched the above criteria were accepted. The main parameter of interest was the rate of functional recovery of the facial nerve after anastomosis. This parameter was compared among all groups with Pearson's X2 test in the SPSS program for Windows. Statistical significance was set at a p level of less than .05. Results: Analysis of the reports indicates that early repair, before 12 months, provides a better outcome. The severity of facial nerve paralysis does not have a negative effect on prognosis. Gunshot wounds and facial neuroma are the worst conditions for favorable facial nerve recovery after anastomosis. Transection of the hypoglossal nerve inevitably results in ipsilateral tongue paralysis and atrophy. Modification of the anastomosis technique seems to resolve this problem. Nevertheless, the effect of modified techniques on facial reanimation is still unclear, because the facial nerve function results were lacking in these reports. Conclusions: Hypoglossal-facial nerve anastomosis is an effective and reliable technique that gives consistent and satisfying results.

scholarly journals Facial Nerve Meningioma: A Case Mimicking Facial Nerve Schwannoma

2020 ◽  
pp. 014556132096258
Author(s):  
Wei Gao ◽  
Dingjing Zi ◽  
Lianjun Lu
Keyword(s):  
Facial Nerve ◽  
Internal Auditory Canal ◽  
Growth Patterns ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Reconstruction ◽  
Radiological Features ◽  
Facial Nerve Reconstruction ◽  
Facial Nerve Schwannoma ◽  
Grade Iii

Facial nerve meningioma is exceedingly rare and tends to affect the geniculate ganglion. We present a case of facial nerve meningioma located in the internal auditory canal with a “labyrinthine tail,” mimicking facial nerve schwannoma. The clinical and radiological features, growth patterns, and surgical management were reviewed. Progressive facial paralysis was the main syndrome, similar to other facial nerve tumors. When facial nerve function is worse than House-Brackmann grade III, surgical resection should be performed with facial nerve reconstruction.

Predicting recovery of facial nerve function following injury from a basilar skull fracture

1991 ◽  
Vol 75 (5) ◽  
pp. 759-762 ◽  
Author(s):  
Andrew B. Adegbite ◽  
Moe I. Khan ◽  
L. Tan
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Recovery Of Function ◽  
Statistical Significance ◽  
Complete Recovery ◽  
Partial Recovery ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Partial Lesion

✓ Twenty-five patients with posttraumatic facial nerve palsy were studied. Partial recovery of function had occurred in 95% of these patients by 18 months after injury. At 5 months posttrauma, there was some recovery in 92.5% of those with a partial lesion compared with 10% of those with a complete lesion. This difference attains statistical significance. Complete recovery of nerve function had occurred by 10.5 months in 53.5% of the patients; in 62% of patients with a partial lesion, complete recovery had occurred by 4 months compared with 0% in those with a complete lesion. This difference also attains statistical significance. There was no statistically significant difference in recovery of function between patients with an immediate as opposed to a delayed onset of facial nerve palsy. It was determined that the degree of palsy had a statistically significant influence on recovery of facial nerve function, whereas the time of onset did not. The data presented support a conservative approach to these injuries and it is recommended that the possibility of surgical treatment should be entertained in patients with complete facial palsy persisting for 12 to 18 months after injury.

scholarly journals Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy

2017 ◽  
Vol 79 (03) ◽  
pp. 309-313 ◽  
Author(s):  
Michael Mooney ◽  
Benjamin Hendricks ◽  
Christina Sarris ◽  
Robert Spetzler ◽  
Randall Porter ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Tumor Diameter ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Microsurgical Resection ◽  
Grade Iii

Objectives This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design A retrospective review. Setting Single-institution cohort. Participants Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures Incidence, House–Brackmann grade. Results Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2.4%. Seven of these nine patients had Koos grade 4 tumors. Mean tumor diameter was 3.0 cm (range: 2.1–4.4 cm), and seven of nine tumors were subtotally resected. All nine patients were followed up clinically for ≥ 6 months. Of the six patients with a preoperative House–Brackmann grade of II, two improved to grade I, three were stable, and one patient worsened to grade III. Of the three patients with grade III or worse, all remained stable at last follow-up. Conclusions Preoperative facial nerve palsy is rare in patients with vestibular schwannoma; it tends to occur in patients with relatively large lesions. Detailed long-term outcomes of facial nerve function after microsurgical resection for these patients have not been reported previously. We followed nine patients and found that eight (89%) of the nine patients had either stable or improved facial nerve outcomes after treatment. Management strategies varied for these patients, including rates of subtotal versus gross-total resection and the use of stereotactic radiosurgery in patients with residual tumor. These results can be used to help counsel patients preoperatively on expected outcomes of facial nerve function after treatment.

scholarly journals Retrosigmoid approach for giant cystic vestibular schwannoma: subperineural dissection technique for facial nerve preservation

2021 ◽  
Vol 5 (2) ◽  
pp. V7
Author(s):  
Ali Tayebi Meybodi ◽  
Robert W. Jyung ◽  
James K. Liu
Keyword(s):  
Facial Nerve ◽  
Thin Layer ◽  
Vestibular Schwannoma ◽  
Cranial Nerve ◽  
Retrosigmoid Approach ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Total Resection ◽  
Nerve Preservation ◽  
Dissection Technique

In this illustrative video, the authors demonstrate retrosigmoid resection of a giant cystic vestibular schwannoma using the subperineural dissection technique to preserve facial nerve function. This thin layer of perineurium arising from the vestibular nerves is used as a protective buffer to shield the facial and cochlear nerves from direct microdissection trauma. A near-total resection was achieved, and the patient had an immediate postoperative House-Brackmann grade I facial nerve function. The operative nuances and pearls of technique for safe cranial nerve and brainstem dissection, as well as the intraoperative decision and technique to leave the least amount of residual adherent tumor, are demonstrated. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21128

Microsurgical management of vestibular schwannoma after failed previous surgery

2016 ◽  
Vol 125 (5) ◽  
pp. 1198-1203 ◽  
Author(s):  
Madjid Samii ◽  
Hussam Metwali ◽  
Venelin Gerganov
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Multivariate Regression Analysis ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Control Group Group

OBJECTIVE Microsurgical treatment of recurrent vestibular schwannoma (VS) is difficult and poses specific challenges. The authors report their experience with 53 cases of surgically treated recurrent VS. Outcome of these tumors was compared to that of primarily operated on VS. Special attention was given to the facial nerve functional outcome. METHODS A retrospective analysis was performed of the patients who underwent surgery for recurrent VS at one institution from 2000 to 2013. The preoperative data, intraoperative findings, and outcome in terms of facial nerve function and improvement of the preoperative symptoms were analyzed and compared with those in a control group of 30 randomly selected patients with primarily operated on VS. A multivariate regression analysis was performed to test the factors that could affect the facial nerve outcome in each group. RESULTS Fifty-three consecutive patients underwent surgery for recurrent VS. Seventeen patients were previously operated on and received postoperative radiosurgery (Group A). Thirty-six patients were previously operated on but did not receive postoperative radiosurgery (Group B). The overall postoperative facial nerve function was significantly worse in Groups A and B in comparison with the control group (Group C). Interestingly, there was no significant difference in the facial nerve outcome among the 3 groups in patients who had good preoperative facial nerve function. The tumor size and the preoperative facial nerve function are variables that significantly affect the facial nerve outcome. Most of the patients showed improvement of the preoperative symptoms, such as trigeminal hypesthesia, gait disturbance, and headache. CONCLUSIONS Complete microsurgical tumor removal is the optimal management for patients with recurrent or regrowing VS. The procedure is safe, associated with favorable facial nerve outcome, and may also improve existing neurological symptoms.

scholarly journals Long-term facial nerve clinical evaluation following vestibular schwannoma surgery

2008 ◽  
Vol 66 (2a) ◽  
pp. 194-198 ◽  
Author(s):  
Rafaela Julia Batista Veronezi ◽  
Yvens Barbosa Fernandes ◽  
Guilherme Borges ◽  
Ricardo Ramina
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Tumor Size ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Facial Function

BACKGROUND: Facial function is important in accompaniment of patients operated on vestibular schwannoma (VS). OBJETIVE: To evaluate long term facial nerve function in patients undergoing VS resection and to correlate tumor size and facial function in a long-term follow-up. METHOD: Transversal study of 20 patients with VS operated by the retrosigmoid approach. House-Brackmann Scale was used preoperatively, immediately after surgery and in a long-term follow-up. Student t test was applied for statistic analysis. RESULTS: In the immediate postoperative evaluation, 65% of patients presented FP of different grades. Improvement of facial nerve function (at least of one grade) occurred in 53% in the long-term follow-up. There was statistically significant difference in facial nerve outcome in long-term follow-up when tumor size was considered (p<0.05). Conclusion: The majority of patients had improvement of FP in a long-term follow-up and tumor size was detected to be a factor associated with the postoperative prognostic.

Facial Nerve Outcome after Acoustic Neuroma Surgery: A Study from the Era of Cranial Nerve Monitoring

1994 ◽  
Vol 111 (5) ◽  
pp. 561-570 ◽  
Author(s):  
Anil K. Lalwani ◽  
Fidelia Yuan-Shin Butt ◽  
Robert K. Jackler ◽  
Lawrence H. Pitts ◽  
Charles D. Yingling
Keyword(s):  
Facial Nerve ◽  
Nerve Stimulation ◽  
Cranial Nerve ◽  
Surgical Removal ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Stimulation Threshold ◽  
Nerve Monitoring ◽  
Facial Function

The introduction of intraoperative cranial nerve monitoring in posterior fossa surgery has greatly aided the surgeon in identification and anatomic preservation of cranial nerves. As a result, the long-term function of the facial nerve continues to improve after removal of acoustic neuroma. Herein, we report our long-term (1 year or greater) facial nerve outcome in 129 patients who underwent surgical removal of their acoustic neuromas with the aid of Intraoperative neurophysiologic monitoring between 1986 and 1990. The facial nerve was anatomically preserved in 99.2% of the patients, and 90% of all the patients had grade 1 or 2 facial nerve function 1 year after surgery. Long-term facial function was inversely correlated with the size of tumor (chi-squared, p < 0.02) and was not related to the side of tumor, the age and sex of the patient, or the surgical approach. In a comparison among tumor groups matched for size, no statistically significant difference in facial nerve outcome between the translabyrinthine and retrosigmoid approaches was detected. The proximal facial nerve stimulation threshold at the end of surgical removal was predictive of long-term facial nerve function (analysis of variance, p < 0.02). At 1 year, 98% (87 of 89) of the patients with electrical thresholds of 0.2 V or less had grade 1 or 2 facial nerve function compared with only 50% (8 of 16) of those with thresholds between 0.21 and 0.6 V. In the era of cranial nerve monitoring, patients can be better advised about long-term facial nerve outcome after surgical intervention. Preoperatively, the size of the tumor is the most critical factor in predicting long-term facial function. Postoperatively, the proximal seventh nerve stimulation threshold at the end of the surgical procedure can be used as one prognostic measure of long-term facial nerve function.

Proximal-to-distal facial amplitude ratios as predictors of facial nerve function after acoustic neuroma excision

1995 ◽  
Vol 83 (6) ◽  
pp. 994-998 ◽  
Author(s):  
Jamal M. Taha ◽  
John M. TEW ◽  
Robert W. Keith
Keyword(s):  
Facial Nerve ◽  
Action Potentials ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Amplitude Ratios ◽  
Tumor Excision ◽  
Compound Action Potentials ◽  
Grade Iii ◽  
Compound Action

✓ Electrophysiological studies (for example, electroneuronography, nerve action potentials, absolute amplitudes of the muscle compound action potentials, and stimulation thresholds) do not accurately predict facial nerve function after the excision of acoustic neuromas. To eliminate individual nerve variability, the authors measured the ratio of the amplitudes of muscle compound action potentials produced by stimulating the facial nerve at the brainstem proximally and at the internal auditory meatus near the transverse crest distally after total tumor excision in 20 patients. The mean tumor size was 36 mm. The facial nerves were anatomically intact in all patients after tumor excision. The follow-up period ranged from 14 to 28 months. Facial nerve outcome was determined by a modified House—Brackmann grading scale. Initial facial nerve function was measured at Days 4 to 7 postoperatively, and final function was the grade at last follow up. The following results were obtained: all patients with proximal-to-distal amplitude ratios greater than 2:3 had Grade III or better initial function and Grade I final facial nerve function; 90% of patients with amplitude ratios between 1:3 and 2:3 had Grade III or worse initial facial nerve function, and 100% of these patients had Grade III or better final facial nerve function; all patients with amplitude ratios less than 1:3 had Grade IV or worse initial and final facial nerve function. The authors conclude that the proximal-to-distal amplitude ratios after acoustic neuroma excision can accurately predict postoperative facial nerve function.

Sign in / Sign up

Export Citation Format

Share Document