Stitchless Fibrin Glue-Aided Facial Nerve Grafting after Cerebellopontine Angle Schwannoma Removal: Technique and Results in 15 Cases

The facial nerve is main motor nerve of the face and its injury leads to total ipsilateral paralysis. There are several surgical procedures in reconstruction of the facial nerve, and the most frequent one is hypoglosso-facial anastomosis. In this study were analysed a series of 69 patients operated on Institute of neurosurgery from 1981 to 2000 year. The most frequent cause of injury was the operation of cerebellopontine angle tumors, as well as the skull base fractures. Hypoglosso-facial anastomosis was done in 57 patients, in 5 cases we performed nerve grafting in the cerebellopontine angle, and in 7 patients the facial nerve was operated peripherally. Results were analyzed in 27 of 57 patients with hipoglosso-facial nerve anastomosis. Functional recovery was achived in 22 (81,4%) patients.

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Facial Nerve Grafting in the Cerebellopontine Angle

The Laryngoscope ◽

10.1097/00005537-200404000-00038 ◽

2004 ◽

Vol 114 (4) ◽

pp. 782-785 ◽

Cited By ~ 8

Author(s):

Mario Sanna ◽

Yogesh Jain ◽

Maurizio Falcioni ◽

Fernando Mancini ◽

Guglielmo Romano

Keyword(s):

Facial Nerve ◽

Cerebellopontine Angle ◽

Nerve Grafting

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

JAMA Facial Plastic Surgery ◽

10.1001/jamafacial.2015.1558 ◽

2016 ◽

Vol 18 (1) ◽

pp. 54-60 ◽

Cited By ~ 24

Author(s):

Monirah Albathi ◽

Sam Oyer ◽

Lisa E. Ishii ◽

Patrick Byrne ◽

Masaru Ishii ◽

...

Keyword(s):

Facial Nerve ◽

Facial Paralysis ◽

Cerebellopontine Angle ◽

Tumor Resection ◽

Nerve Grafting ◽

Cerebellopontine Angle Tumor

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Facial Nerve Grafting in the Cerebellopontine Angle

Skull Base ◽

10.1055/s-2005-916527 ◽

2005 ◽

Vol 15 (S 2) ◽

Author(s):

Maurizio Falcioni ◽

A. Russo ◽

G. Romano ◽

M. Sanna

Keyword(s):

Facial Nerve ◽

Cerebellopontine Angle ◽

Nerve Grafting

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Cerebellopontine Angle Surgery Assisted by Continuous Mapping of the Facial Nerve Via the Ultrasonic Aspirator

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1709162 ◽

2020 ◽

Author(s):

Marco Cenzato ◽

Roberto Stefini ◽

Francesco Zenga ◽

Maurizio Piparo ◽

Alberto Debernardi ◽

...

Keyword(s):

Electrical Stimulation ◽

Facial Nerve ◽

Cerebellopontine Angle ◽

Continuous Mapping ◽

Cost Effective ◽

Current Intensity ◽

Vestibular Schwannomas ◽

Constant Current ◽

Surgical Workflow ◽

Ultrasonic Aspirator

Abstract Background Cerebellopontine angle (CPA) surgery carries the risk of lesioning the facial nerve. The goal of preserving the integrity of the facial nerve is usually pursued with intermittent electrical stimulation using a handheld probe that is alternated with the resection. We report our experience with continuous electrical stimulation delivered via the ultrasonic aspirator (UA) used for the resection of a series of vestibular schwannomas. Methods A total of 17 patients with vestibular schwannomas, operated on between 2010 and 2018, were included in this study. A constant-current stimulator was coupled to the UA used for the resection, delivering square-wave pulses throughout the resection. The muscle responses from upper and lower face muscles triggered by the electrical stimulation were displayed continuously on multichannel neurophysiologic equipment. The careful titration of the electrical stimulation delivered through the UA while tapering the current intensity with the progression of the resection was used as the main strategy. Results All operations were performed successfully, and facial nerve conduction was maintained in all patients except one, in whom a permanent lesion of the facial nerve followed a miscommunication to the neurosurgeon. Conclusion The coupling of the electrical stimulation to the UA provided the neurosurgeon with an efficient and cost-effective tool and allowed a safe resection. Positive responses were obtained from the facial muscles with low current intensity (lowest intensity: 0.1 mA). The availability of a resection tool paired with a stimulator allowed the surgeon to improve the surgical workflow because fewer interruptions were necessary to stimulate the facial nerve via a handheld probe.

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Intraoperative transcranial facial motor evoked potential monitoring in surgery of cerebellopontine angle tumors predicts early and late postoperative facial nerve function

Clinical Neurophysiology ◽

10.1016/j.clinph.2020.12.025 ◽

2021 ◽

Vol 132 (4) ◽

pp. 864-871

Author(s):

Ryo Hiruta ◽

Taku Sato ◽

Takeshi Itakura ◽

Masazumi Fujii ◽

Jun Sakuma ◽

...

Keyword(s):

Facial Nerve ◽

Cerebellopontine Angle ◽

Evoked Potential ◽

Motor Evoked Potential ◽

Nerve Function ◽

Facial Nerve Function ◽

Cerebellopontine Angle Tumors ◽

Evoked Potential Monitoring ◽

Potential Monitoring

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Preoperative identification of the facial nerve in patients with large cerebellopontine angle tumors using high-density diffusion tensor imaging

Journal of Neurosurgery ◽

10.3171/2011.12.jns111404 ◽

2012 ◽

Vol 116 (4) ◽

pp. 697-702 ◽

Cited By ~ 32

Author(s):

Neil Roundy ◽

Johnny B. Delashaw ◽

Justin S. Cetas

Keyword(s):

Diffusion Tensor Imaging ◽

Facial Nerve ◽

Cerebellopontine Angle ◽

Diffusion Tensor ◽

Tumor Resection ◽

High Density ◽

Imaging Method ◽

Study Objective ◽

Nerve Preservation ◽

Imaging Results

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.

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