Abstract
Objective: 1) Understand that the vagus nerve is at risk during excision of lesions of the cerebellopontine angle (CPA), with a potential impact on voice and swallowing function. 2) Describe the incidence and risk factors for vagal palsy in patients undergoing excision of CPA tumors.
Method: Retrospective chart review of 181 consecutive patients undergoing surgical excision of CPA pathology from January 1, 2008, to December 31, 2010, at Johns Hopkins Hospital. Unilateral vagal palsy was identified by laryngoscopy or cine-esophagram, and clinical variables were collected from medical records.
Results: Unilateral vagal palsy was identified in 19 out of 181 (10%) patients. Vocal fold motion impairment (VFMI) in combination with pharyngeal palsy was more common than VFMI or pharyngeal palsy alone. Those with vagal palsy had a larger mean tumor size (30 mm) than those without vagal palsy (20 mm, pp with vagal palsy (67%).
Conclusion: Voice and swallowing function can be affected by surgical excision of pathology of the CPA. Tumor size is an independent risk factor for postoperative vagal palsy, with consequences for prolonged hospital stay, aspiration, and voice, and swallowing impairment.
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