Peservation of Facial Nerve Function after Acoustic Neuroma Surgery

Kim, Chong Sun; Chang, Sun O; Jung, Hee Won; Oh, Seung Ha; Yu, Won Seok; Jeon, Sang Jun

Abstract

BACKGROUND AND OBJECTIVES: Facial nerve paralysis is a visible complication following acoustic neuroma surgery. The pro-gnostic factors which predict postoperative facial nerve function after acoustic neuroma surgery were investigated.
MATERIALS AND METHODS
Fifty one patients with acoustic neuroma operated with neurotological approaches from March, 1987 to May, 1997 at Seoul national university hospital were studied by retrospective medical record review. Patient groups were divided according to surgical approach which were selected on the basis of tumor location and size as well as the need for hearing preservation. They were also divided according to the extent of tumor, preoperative facial nerve function, and tumor size. Under the House-Brackmann grading system, preservation of facial nerve function for each of the groups was analyzed before the operation, immediately after the operation (7th day), and at the time of last follow up (>12 month). The mean age of patients was 49.3 years, ranging from 29 to 72 years. Spearman Correlation analysis was used for statistical evaluation.
RESULTS
The extent of tumor or different surgical approaches of tumor removal, such as translabyrinthine, transotic, middle fossa, and the combined approach, did not influence on facial nerve preservation. Pre-operative and immediate postoperative facial nerve functions as well as tumor size were important prognostic factors in the long term facial nerve function. As the size of tumor increased, the long term postoperative facial nerve function became poor.
CONCLUSION
Early diagnosis and surgery are required for small size tumors in order to have good facial nerve function following acoustic neuroma surgery.