The aim of the present study was to ascertain the precise fraction of vestibular schwannoma cases that recover to normal function after postoperative total facial nerve paralysis and to compare our results with those presented in the literature. This was a retrospective case review of 631 cases. Among the 132 cases with immediate postoperative facial nerve palsy (House Brackmann [HB] grade VI), only 2 (1.5%) recovered to normal function (HB grade I). In an attempt to compare our results with those of other series in the literature, we found a large variation in the incidence of recovery of this group of patients to grade I, ranging from 0% to 50%. Our analysis of the reported data revealed widely varying methods of data collection and presentation, making a scientifically valid comparison particularly difficult. According to our data, complete (HB grade I) or near-complete (HB grade II) facial nerve function recovery from an immediate postoperative grade VI palsy is extremely rare.
EbersoldMJHarnerSGBeattyCWHarperCMJrQuastLM. Current results of the retrosigmoid approach to acoustic neurinoma. J Neurosurg1992; 76: 901–9
2.
KaylieDMGilbertEHorganMADelashawJBMcMenomeySO. Acoustic neuroma surgery outcomes. Otol Neurotol2001; 22: 686–9
3.
SamiiMMatthiesC.Management of 1000 vestibular schwannomas (acoustic neuromas): surgical management and results with an emphasis on complications and how to avoid them. Neurosurgery1997; 40: 11–23
4.
MamikogluBWietRJEsquivelCR. Translabyrinthine approach for the management of large and giant vestibular schwannomas. Otol Neurotol2002; 23: 224–7
5.
LanmanTHBrackmannDEHitselbergerWESubinB.Report of 190 consecutive cases of large acoustic tumors (vestibular schwannoma) removed via the translabyrinthine approach. J Neurosurg1999; 90: 617–23
6.
SterkersJMMorrisonGASterkersOEl-DineMM. Preservation of facial, cochlear, and other nerve functions in acoustic neuroma treatment. Otolaryngol Head Neck Surg1994; 110: 146–55
7.
LalwaniAKButtFYJacklerRKPittsLHYinglingCD. Facial nerve outcome after acoustic neuroma surgery: a study from the era of cranial nerve monitoring. Otolaryngol Head Neck Surg1994; 111: 561–70
WietRJMamikogluBOdomLHoistadDL. Long-term results of the first 500 cases of acoustic neuroma surgery. Otolaryngol Head Neck Surg2001; 124: 645–51
10.
TonnJCSchlakeHPGoldbrunnerRMilewskiCHelmsJRoosenK.Acoustic neuroma surgery as an interdisciplinary approach: a neurosurgical series of 508 patients. J Neurol Neurosurg Psychiatry2000; 69: 161–6
11.
FentonJEChinRYFaganPASterkersOSterkersJM. Predictive factors of long-term facial nerve function after vestibular schwannoma surgery. Otol Neurotol2002; 23: 388–92
12.
ArriagaMALuxfordWMAtkinsJSJrKwartlerJA. Predicting long-term facial nerve outcome after acoustic neuroma surgery. Otolaryngol Head Neck Surg1993; 108: 220–4
13.
AxonPRRamsdenRT. Intraoperative electromyography for predicting facial function in vestibular schwannoma surgery. Laryngoscope1999; 109: 922–6
14.
McElveenJTJrBelmonteRGFukushimaTBullardDE. A review of facial nerve outcome in 100 consecutive cases of acoustic tumor surgery. Laryngoscope2000; 110: 1667–72
15.
NakaoYPiccirilloEFalcioniMPrediction of facial nerve outcome using electromyographic responses in acoustic neuroma surgery. Otol Neurotol2002; 23: 93–5
16.
NakaoYPiccirilloEFalcioniMTaibahAKobayashiTSannaM.Electromyographic evaluation of facial nerve damage in acoustic neuroma surgery. Otol Neurotol2001; 22: 554–7
17.
CrossTSheardCEGarrudPNikolopoulosTPO'DonoghueGM. Impact of facial paralysis on patients with acoustic neuroma. Laryngoscope2000; 110: 1539–42
KunihiroTKanzakiJShiobaraRInoueYKurashimaK.Long-term prognosis of profound facial nerve paralysis secondary to acoustic neuroma resection. ORL J Otorhinolaryngol Relat Spec1999; 61: 98–102
22.
KunihiroTKanzakiJYoshiharaSSatohY.Analysis of the prognosis and the recovery process of profound facial nerve paralysis secondary to acoustic neuroma resection. ORL J Otorhinolaryngol Relat Spec1994; 56: 331–3
23.
SilversteinHRosenbergSIFlanzerJSeidmanMD. Intraoperative facial nerve monitoring in acoustic neuroma surgery. Am J Otol1993; 14: 524–32
24.
SilversteinHWillcoxTOJrRosenbergSISeidmanMD. Prediction of facial nerve function following acoustic neuroma resection using intraoperative facial nerve stimulation. Laryngoscope1994; 104: 539–44
25.
ArriagaMAChenDA. Facial function in hearing preservation acoustic neuroma surgery. Arch Otolaryngol Head Neck Surg2001; 127: 543–6
26.
BruzzoMBroderLChaysAMagnanJ.Our current results with acoustic neurinoma surgery [in French]. Ann Otolaryngol Chir Cervicofac2000; 117: 110–7
27.
KwartlerJALuxfordWMAtkinsJSheltonC.Facial nerve monitoring in acoustic tumor surgery. Otolaryngol Head Neck Surg1991; 104: 814–7
28.
NadolJBJrLevineROjemannRGMartuzaRLMontgomeryWWde SandovalPK. Preservation of hearing in surgical removal of acoustic neuromas of the internal auditory canal and cerebellar pontine angle. Laryngoscope1987; 97: 1287–94
29.
NadolJBJrChiongCMOjemannRGPreservation of hearing and facial nerve function in resection of acoustic neuroma. Laryngoscope1992; 102: 1153–8
30.
EssesBALaRouereMJGrahamMD. Facial nerve outcome in acoustic tumor surgery. Am J Otol1994; 15: 810–2
31.
SymsCAIIIHouseJRIIILuxfordWMBrackmannDE. Preoperative electroneuronography and facial nerve outcome in acoustic neuroma surgery. Am J Otol1997; 18: 401–3
32.
SamiiMMatthiesC.Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve — preservation and restitution of function. Neurosurgery1997; 40: 684–94
33.
SatarBJacklerRKOghalaiJPittsLHYatesPD. Risk-benefit analysis of using the middle fossa approach for acoustic neuromas with >10 mm cerebellopontine angle component. Laryngoscope2002; 112: 1500–6
34.
IrvingRMJacklerRKPittsLH. Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg1998; 88: 840–5
35.
DarrouzetVGuerinJAouadNDutkiewiczJBlayneyAWBebearJP. The widened retrolabyrinthine approach: a new concept in acoustic neuroma surgery. J Neurosurg1997; 86: 812–21
36.
RosenfeldRM. The seven habits of highly effective data users. Otolaryngol Head Neck Surg1998; 118: 144–58
