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.

Early Management of Facial Nerve Paralysis

1995 ◽  
Vol 112 (5) ◽  
pp. P153-P153
Author(s):  
Samuel H. Selesnick ◽  
Jed Kwartler
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Management Plan ◽  
Facial Nerve Paralysis ◽  
Educational Objectives ◽  
Early Management ◽  
Nerve Paralysis ◽  
Facial Nerve Injury ◽  
Facial Nerve Anatomy

Educational objectives: To understand facial nerve anatomy and likely sites of pathology and to develop a management plan for acute 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 palsy in mastoid surgery

1997 ◽  
Vol 111 (2) ◽  
pp. 113-116 ◽  
Author(s):  
E. L. K. Nilssen ◽  
P. J. Wormald
Keyword(s):  
At Risk ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Facial Nerve Palsy ◽  
Topical Therapy ◽  
Facial Nerve Injury ◽  
Management Protocol ◽  
Lost To Follow Up ◽  
Mastoid Surgery

AbstractThe risk of facial nerve injury during mastoid surgery has decreased substantially since the advent of the microscope and the otological drill. However, the facial nerve remains at risk during mastoid surgery with the present day incidence suggested to be one per cent. Despite the severity of this complication there are no recent studies that accurately quantify the incidence or discuss its management. The aims of this study were to identify the risk of facial nerve injury for both the specialist as well as the trainee specialist and to review a management protocol for this complication. During the 10-year period from 1985 to 1994, 1024 consecutive mastoidectomies were reviewed. A total of 17 palsies was identified, seven were complete and 10 were incomplete. Of the seven complete palsies, four patients had decompression only and recovered to House Brackmann Grade 2 or better while three patients had decompression and grafting, of these, two were available for follow-up and recovered to House Brackmann Grade 4 only. All the partial palsies, barring one lost to follow-up, who were treated conservatively with pack removal, toilet and topical therapy recovered to House Brackmann Grade 2 or better. A management protocol followed for the above patients is presented and the results analysed. Specific operations and manoeuvres which may put the facial nerve at risk intra-operatively are also discussed.

scholarly journals Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report

2020 ◽  
Vol 2 (6) ◽  
pp. 1-1
Author(s):  
Yazheng Dang ◽  
Mingwei Wang ◽  
Wei Li ◽  
Hongxiang Gao ◽  
Shigao Huang ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Facial Nerve Injury
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