Facial Nerve Involvement During Temporal Bone Resection: Overall Survival And Locoregional Recurrence Outcomes.

Purpose: Facial nerve resection is often required in lateral temporal bone resection for tumors extending to the lateral skull base. Limited data exists to guide facial nerve reanimation strategies. Methods: This is a retrospective cohort study. Patients undergoing lateral temporal bone resection in a national referral center were included and divided into two groups: facial nerve preservation or resection. Survival and locoregional recurrence outcomes were analyzed by Kaplan-Meier survival analysis. Prognostic factors were identified using univariate and multivariate analysis. Facial nerve reconstructive methods were collected.Results: 39 patients were included with 20 having facial nerve resection at surgery. Squamous cell carcinoma (SCC) was the most common pathology. 48% of patients died during follow-up. Mean overall survival (OS) was 27 months and mean time to locoregional recurrence (LRR) 23 months in the facial nerve preservation group. Mean OS was 16 months and mean time to LRR was 13 months in the facial nerve resection groups (logrank OS p=0.330 and LRR p=0.445). 75% of patients in the facial nerve resection group had static facial nerve reanimation using tarsorrhaphy, gold-weight eyelid implant and fascia lata sling. Middle ear cavity extension was a negative predictor of OS and LRR.Conclusion: Facial nerve resection during lateral temporal bone surgery is associated with poor overall survival and locoregional control outcomes. Multidisciplinary surgical management and static facial reanimation should be offered to maintain function and quality of life in this group of patients.