Rehabilitation of cranial nerve deficits after neurotologic skull base surgery.

Damage to any one of these nerves results in sufficient morbidity to warrant therapy; however, most patients will compensate for isolated loss of function. It is with multiple nerve injuries, as often seen in glomus surgery with the resection of cranial nerves IX, X, and XII that the full efforts of the rehabilitation team are called on. After vocal cord medialization and palatal adhesion, younger healthier patients will eventually resume adequate oral intake. However, the time it requires to return to a reasonably enjoyable diet often extends up to 1 year postoperatively. A few never attain the goal of enjoyable intake and continue to struggle to maintain adequate nutrition. The latter situation is the rule, not the exception, in the elderly population. Our experience over the years has led us to a more conservative treatment of glomus tumors in the elderly debilitated patient.