Recovery of the sutured facial nerve after removal of acoustic neuroma in patients with neurofibromatosis-2.
The authors compared the long-term recovery of sutured facial nerves after the removal of 8 neurofibromatosis-2 (NF2)-associated and 22 non-NF2 acoustic neuromas. The patients were from a series of 270 patients operated on for an acoustic neuroma between 1979 and 1989. The assessment was done with a modified House and Brackmann scale from video recordings. At least some facial movement or tone was achieved (Grade 5 or better) in all but three patients, but in none was the recovery excellent. The facial function, judged by the overall appearance in movement, recovered less in patients with NF2 (P = 0.048); a moderately good recovery (Grade 3 or better) was seen in one patient of eight with NF2, as compared with 13 of 22 with non-NF2. In conclusion, if the tumor cannot be peeled off easily from the facial nerve in patients with NF2, leaving a fragment of tumor behind is preferable to cutting and suturing the facial nerve.
Blomstedt
G C
GC
Department of Neurosurgery, Helsinki University Hospital, Finland.
Jääskeläinen
J E
JE
Pyykkö
I
I
Ishizaki
H
H
Troupp
H
H
Palva
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005152:Facial Muscles / Q000294:innervation; D005154:Facial Nerve / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D009129:Muscle Tonus / Q000502:physiology; D009416:Nerve Regeneration / Q000502:physiology*; D016518:Neurofibromatosis 2 / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D013536:Suture Techniques; D014741:Video Recording