Facial Nerve Outcome

Facial nerve function can be assessed using the House-Brackmann scale [13]. This grades facial weakness as normal (Grade I) through mild (II), moderate (III), moderately severe (IV), severe (V) and total paralysis (VI). This method of assessment has a high degree of interobserver reliability and has become widely adopted.

In the Cambridge series (1982-1998), the facial nerve was anatomically intact following tumor resection in 94% of cases. Loss of the facial nerve in patients with small tumors was exceptional. In the 372 patients with long-term facial nerve follow-up, 76% of patients undergoing translabyrinthine surgery achieved a Grade I-III result. Retrosigmoid resection results were slightly better, with 79% achieving a Grade I-III result at 12 months. Table 14.3 shows results for facial nerve function related to tumor size. When the series is analyzed in 5-year time-blocks the Grade I-III facial nerve results improved from 56% (1982-1987), through 81% (1988-1992) to 85% (1993-1997). This indicates that the experience of the surgical team is critical in facial nerve preservation surgery [14].

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