A case of delayed loss of facial nerve function after acoustic neuroma surgery

We report on the uncommon delay of facial palsy in the course of a patient who underwent surgery for a left sided acoustic neuroma. Facial nerve function was preserved without clinical or electrophysiological deficit during the immediate postoperative phase and then lost almost totally over two days. This began on the seventh postoperative day. Recovery became visible under hypervolemic hemodilution and glucocorticoids a few days later and was complete after three months. Vasospasm in combination with neural edema might account for this uncommon delay of postoperative facial nerve deterioration.