Facial nerve function after vestibular schwannoma surgery

Area of Science:

• Neurosurgery
• Otolaryngology
• Neurology

Background:

• Vestibular schwannoma (VS) surgery aims to preserve facial nerve (FN) function.
• Assessing long-term postoperative FN function is crucial for patient outcomes.

Purpose of the Study:

• To evaluate long-term postoperative facial nerve (FN) function in patients who underwent vestibular schwannoma (VS) surgery.
• To identify factors influencing FN function after VS resection.

Main Methods:

• Retrospective review of 1151 patients with isolated VS and normal preoperative FN function.
• Facial nerve function assessed using the House-Brackmann (HB) scale postoperatively (minimum 12-month follow-up).
• Analysis of tumor size and surgical approach in relation to FN function outcomes.

Main Results:

• Of 1052 patients with anatomically preserved FNs and total tumor removal, 65% had HB Grade I/II, 29.4% had Grade III, and 5.6% had unsatisfactory results (Grades IV-VI).
• FN function deteriorated with increasing tumor size.
• Tumor size was the main factor influencing postoperative FN function.

Conclusions:

• Tumor size is the primary determinant of postoperative facial nerve function after VS surgery.
• An optimal tumor size for surgery is identified as < 1 cm, with a cutoff for satisfactory results around 2 cm.
• Early diagnosis and appropriate surgical approach are critical for preserving FN function.