Prognostic factors for postsurgical hearing and facial nerve function in cases of cerebellopontine angle-tumours

1985 ◽  
Vol 78 (1-2) ◽  
pp. 21-27 ◽  
Author(s):  
Th. Lenarz ◽  
W. Sachsenheimer
2021 ◽  
Author(s):  
Kaith K Almefty ◽  
Wenya Linda Bi ◽  
Walid Ibn Essayed ◽  
Ossama Al-Mefty

Abstract Facial nerve schwannomas are rare and can arise from any segment along the course of the facial nerve.1 Their location and growth patterns present as distinct groups that warrant specific surgical management and approaches.2 The management challenge arises when the facial nerve maintains good function (House-Brackmann grade I-II).3 Hence, a prime goal of management is to maintain good facial animation. In large tumors, however, resection with facial nerve function preservation should be sought and is achievable.4,5  While tumors originating from the geniculate ganglion grow extradural on the floor of the middle fossa, they may extend via an isthmus through the internal auditory canal to the cerebellopontine angle forming a dumbbell-shaped tumor. Despite the large size, they may present with good facial nerve function. These tumors may be resected through an extended middle fossa approach with preservation of facial and vestibulocochlear nerve function.  The patient is a 62-yr-old man who presented with mixed sensorineural and conductive hearing loss and normal facial nerve function. Magnetic resonance imaging (MRI) revealed a large tumor involving the middle fossa, internal auditory meatus, and cerebellopontine angle.  The tumor was resected through an extended middle fossa approach with a zygomatic osteotomy and anterior petrosectomy.6 A small residual was left at the geniculate ganglion to preserve facial function. The patient did well with hearing preservation and intact facial nerve function. He consented to the procedure and publication of images.  Image at 1:30 © Ossama Al-Mefty, used with permission. Images at 2:03 reprinted from Kadri and Al-Mefty,6 with permission from JNSPG.


2020 ◽  
Vol 19 (5) ◽  
pp. 502-509
Author(s):  
Alexander V Zotov ◽  
Jamil A Rzaev ◽  
Sergey V Chernov ◽  
Alexander B Dmitriev ◽  
Anton V Kalinovsky ◽  
...  

Abstract BACKGROUND Facial nerve paralysis (FP) is a possible complication of cerebellopontine angle tumor surgery. Several donor nerves have been used in the past for facial reanimation. We report the results of 30 cases of masseter-to-facial anastomosis. OBJECTIVE To prospectively evaluate the efficacy of V to VII anastomosis after FP. METHODS In a prospective study, we included 30 consecutive patients with FP (20 women and 10 men) whose mean age was 48.8 yr (32-76 yr). In almost all cases, FP developed after cerebellopontine angle tumor surgery (29 patients), whereas in one case, FP occurred after skull base trauma. Pre- and postoperative evaluation of facial nerve function was performed using the House-Brackmann (HB) scale and the Sokolovsky scale, as well as by electromyography. Follow-up ranged from 11 to 51 mo and averaged 22 mo. RESULTS All patients achieved functional recovery of the facial nerve from VI to either III or IV HB degree. Patients with short time FP showed significantly better postoperative recovery. CONCLUSION The results of the V to VII anastomosis demonstrate a significant improvement of facial nerve function and virtually no complications.


1995 ◽  
Vol 112 (2) ◽  
pp. 228-234 ◽  
Author(s):  
B SCHALLER ◽  
R HEILBRONNER ◽  
C PFALTZ ◽  
R PROBST ◽  
O GRATZL

1992 ◽  
Vol 101 (10) ◽  
pp. 821-826 ◽  
Author(s):  
Mirko Tos ◽  
Jens Thomsen ◽  
Mahmoud Youssef ◽  
Suat Turgut

Forty-six consecutive video-recorded translabyrinthine operations at Gentofte Hospital, for tumors of 5 to 25 mm, were investigated for possible damage to the facial nerve from cauterization, suction, stretching, pushing, and other instrumental trauma at the following regions: fundus, internal meatus, porus, cerebellopontine angle, and brain stem. House-Brackmann grading of the postoperative facial nerve function was determined from the patient records for the 1st, 3rd, and 10th days and 3 months and 6 months postoperatively, as well as the final status. Suction on the nerve seems to be the most important factor for perioperative facial nerve damage. The most common site of damage was the porus region. This investigation shows thermic drilling lesions to be very relevant. There was no correlation between the degree and character of damage and the postoperative facial nerve function. In eight patients we cannot explain the postoperative facial palsy.


2019 ◽  
Vol 139 (6) ◽  
pp. 541-546 ◽  
Author(s):  
Jungmin Ahn ◽  
Nam-Gyu Ryu ◽  
Jihyun Lim ◽  
Minwoong Kang ◽  
Ho Jun Seol ◽  
...  

Neurosurgery ◽  
2005 ◽  
Vol 56 (3) ◽  
pp. 560-570 ◽  
Author(s):  
Ivan Ciric ◽  
Jin-cheng Zhao ◽  
Sami Rosenblatt ◽  
Richard Wiet ◽  
Brian O'shaughnessy

Abstract IN THIS REPORT, we discuss the pertinent bony, arachnoid, and neurovascular anatomy of vestibular schwannomas that has an impact on the surgical technique for removal of these tumors, with the goal of facial nerve and hearing preservation. The surgical technique is described in detail starting with anesthesia, positioning, and neurophysiological monitoring and continuing with the exposure, technical nuances of tumor removal, hemostasis, and closure. Positive prognostic factors for hearing preservation are also highlighted.


Skull Base ◽  
1991 ◽  
Vol 1 (03) ◽  
pp. 171-176 ◽  
Author(s):  
P. J. Kirkpatrick ◽  
G. Watters ◽  
A. J. Strong ◽  
J. R. Walliker ◽  
M. J. Gleeson

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