Woo Seok Kang1, Jae Joon Han2, Jihye Rhee3, Jun Ho Lee4, Ja-Won Koo5, Jong Woo Chung1. 1. Department of Otorhinolaryngology-Head - Neck Surgery, Asan Medical Center, Seoul, Korea, Republic Of. 2. Department of Otorhinolaryngology-Head - Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Korea, Republic Of. 3. Department of Otorhinolaryngology, Veterans Health Service Medical Center, Seoul, Korea, Republic Of. 4. Department of Otorhinolaryngology-Head - Neck Surgery, Seoul National University Hospital, Seoul, Korea, Republic Of. 5. Department of Otorhinolaryngology-Head - Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea, Republic Of.
Abstract
OBJECTIVES: The aim of this study was to evaluate the preoperative and postoperative facial nerve (FN) function in patients with FN schwannoma (FNS) and analyze the duration of preoperative facial palsy according to the preoperative and postoperative facial function. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 29 patients with FNS who underwent surgery. We evaluated the FN function according to the type of FN manipulation and location of the anastomoses in the cable nerve graft, and we also analyzed the duration of facial palsy according to the facial function before and after surgery. RESULTS: All 4 patients who underwent nerve-stripping surgery had the House-Brackmann (H-B) Grade III, 12 of 21 who underwent a cable nerve graft had the H-B Grade III or better postoperatively, and all 4 who underwent a hypoglossal facial crossover had the H-B Grade IV. Patients who underwent cable nerve grafting were more likely to have better FN function when the proximal anastomosis site was located in the internal auditory canal, geniculate ganglion, tympanic segment of FN, and distal end in the mastoid segment of FN. The duration of preoperative facial palsy was statistically shorter in patients with better postoperative facial function. CONCLUSION: Surgery can be considered in patients with FNS who have the H-B Grade III or worse. A shorter duration of facial palsy prior to surgery resulted in better postoperative facial function.
OBJECTIVES: The aim of this study was to evaluate the preoperative and postoperative facial nerve (FN) function in patients with FN schwannoma (FNS) and analyze the duration of preoperative facial palsy according to the preoperative and postoperative facial function. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 29 patients with FNS who underwent surgery. We evaluated the FN function according to the type of FN manipulation and location of the anastomoses in the cable nerve graft, and we also analyzed the duration of facial palsy according to the facial function before and after surgery. RESULTS: All 4 patients who underwent nerve-stripping surgery had the House-Brackmann (H-B) Grade III, 12 of 21 who underwent a cable nerve graft had the H-B Grade III or better postoperatively, and all 4 who underwent a hypoglossal facial crossover had the H-B Grade IV. Patients who underwent cable nerve grafting were more likely to have better FN function when the proximal anastomosis site was located in the internal auditory canal, geniculate ganglion, tympanic segment of FN, and distal end in the mastoid segment of FN. The duration of preoperative facial palsy was statistically shorter in patients with better postoperative facial function. CONCLUSION: Surgery can be considered in patients with FNS who have the H-B Grade III or worse. A shorter duration of facial palsy prior to surgery resulted in better postoperative facial function.
Authors: Jayesh Doshi; Richard Heyes; Simon Richard Mackenzie Freeman; Gillian M Potter; Charlotte Lucy Ward; Scott Alexander Rutherford; Andrew Thomas King; Richard Thomas Ramsden; Simon Kingsley Wickham Lloyd Journal: Otol Neurotol Date: 2015-06 Impact factor: 2.311