Prognostic factors for the incidence and recovery of delayed facial nerve palsy after vestibular schwannoma resection

Abstract

Although patients with DFP did not exhibit any distinguishable characteristics when compared with patients without postoperative facial palsy, our analysis identified significant differences in patients with palsy presenting immediately postoperatively. Further study of patients with DFP should be undertaken to predict its incidence following VS resection.

Contemporary Surgical Management of Vestibular Schwannomas

“…The incidence of delayed facial palsy in our series was quite low compared with published rates of between 4.8% and 29%. [35][36][37][38][39] Our 6 patients were treated with a tapered course of dexamethasone; 2 patients demonstrated excellent facial function recovery in a few months, 1 showed partially recovery, and the other 2 still had palsy at their last follow-up (13 and 51 months). One patient who presented with H-B IV palsy missed follow-up.…”

“…The cause of delayed facial palsy is thought to be neural edema, inflammation, vasospasm, ischemia, venous outflow obstruction, nerve compression from fat packing, iatrogenic injury, fluid shifts, sterile arachnoiditis after CPA surgery, or reactivation of a latent herpesvirus. [35][36][37][38][39][40][41][42][43][44] Most delayed facial palsy cases demonstrated favorable recovery (79%-100%), and only tumor size has been shown to correlate inversely with the degree of FN recovery at 1 year. 36 For hearing preservation, because of the extreme fragility of the nerve, the surgeon must either perform a smooth separation of the tumor or opt for NTR or STR.…”

Patient-perceived long-term communication and swallow function following cerebellopontine angle surgery

“…Cranial nerve deficits are not unexpected following surgical management of vestibular schwannomas. In the immediate postoperative period, facial nerve palsy has been reported to occur in ≈1/3 of patients undergoing surgery for vestibular schwannoma, with a significant improvement in nerve function noted in the first postoperative year for the majority of patients . Although vagal nerve palsy is uncommonly reported, the proximity of the tenth cranial nerve complex to the internal auditory canal (IAC) may lead to temporary or permanent dysfunction after surgery to this region.…”

“…In the immediate postoperative period, facial nerve palsy has been reported to occur in 1/3 of patients undergoing surgery for vestibular schwannoma, with a significant improvement in nerve function noted in the first postoperative year for the majority of patients. [1][2][3] Although vagal nerve palsy is uncommonly reported, the proximity of the tenth cranial nerve complex to the internal auditory canal (IAC) may lead to temporary or permanent dysfunction after surgery to this region. Best et al documented unilateral vagus nerve palsy in 10% of patients in the postoperative period following surgery to the cerebellopontine angle (CPA).…”

Delayed facial palsy after tympanomastoid surgery: A report of 15 cases

“…Its incidence varies greatly in different reports due to various enrollment criteria and definition of DFP, ranging from 0.38% to 1.4% [1][2][3][4]. Different from DFP after vestibular schwannomas [5][6][7], the information about larger case series of DFP after tympanomastoid surgery is rather limited. This study enrolled 15 patients of DFP after tympanomastoid surgery, and aimed at discussing its possible etiology and outcomes.…”