Facial nerve management in cranial base surgery

Area of Science:

• Neurosurgery
• Oncologic Surgery
• Facial Nerve Surgery

Background:

• Cranial base surgery frequently necessitates facial nerve manipulation.
• Understanding outcomes of different facial nerve interventions is crucial for surgical planning and patient counseling.

Purpose of the Study:

• To review outcomes of facial nerve manipulation in cranial base surgery.
• To assess functional recovery after nerve displacement, transection, or resection and repair.
• To investigate factors influencing facial function post-surgery, particularly in oncologic cases.

Main Methods:

• Retrospective review of 124 patients undergoing cranial base surgery with facial nerve manipulation.
• Categorization of interventions: nerve displacement, selective transection, oncologic resection with grafting, and palliative resection with tissue reconstruction.
• Assessment of facial function recovery and correlation with preoperative status and oncologic indications.

Main Results:

• Most patients undergoing nerve displacement or selective transection achieved satisfactory facial function.
• Facial nerve resection for oncologic reasons with grafting showed variable recovery; quality correlated with injury severity.
• No correlation found between preoperative weakness and nerve graft function, but preoperative weakness suggested poorer oncologic prognosis.
• Patients with palliative resection and tissue reconstruction had deficits addressed via regional tissue.

Conclusions:

• Facial nerve displacement and selective transection are generally associated with good functional outcomes in cranial base surgery.
• While nerve grafting can restore function after oncologic resection, preoperative weakness is a negative prognostic indicator.
• Surgical approach and oncologic status significantly impact facial nerve function recovery and patient prognosis.