Early reinnervation of facial muscles after removal of large and giant vestibular schwannomas

Abstract

Removal of large and giant vestibular schwannomas is associated with the risk of paresis of facial muscles. The probability of anatomical damage to the facial nerve is 10.3–14.0%. Treatment of mimic muscle paralysis is one of the most difficult problems in reconstructive surgery. In this study, the results of neurotization of the facial nerve by masticatory were evaluated in 4 patients after its damage during the removal of large and giant vestibular schwannomas. Neurotization was carried out 10–14 days after tumor removal. With direct neurotization of the facial nerve by masticatory in all patients, it was possible to achieve the function of mimic muscles, corresponding to grade II–III according to the House–Brackmann scale. The use of an autoinsert from the greater ear nerve led to a worse result (House–Brackmann IV).