Predictive value of facial nerve electrophysiologic stimulation thresholds in cerebellopontine-angle surgery.
The predictive value of intraoperative stimulation thresholds for facial nerve function, using a constant-current system, was examined in 49 patients undergoing resection of cerebellopontine-angle tumors. Immediately after surgery, 75% of the 0.1-mA threshold group, 42% of the 0.2-mA group, and 18% of the 0.3-mA or greater group had good (grade I or II) facial nerve function. One year after surgery, 90% of the 0.1-mA group, 58% of the 0.2-mA group, and 41% of the 0.3-mA or greater group had grade I or II function. A statistically significant breakpoint of 0.2 mA was found to predict good postoperative facial function. Delayed facial paralysis occurred in 22% of patients, but the prognosis for these patients was favorable. Both current stimulation threshold and duration are necessary for a meaningful comparison of data between investigators.
Selesnick
S H
SH
Department of Otorhinolaryngology, The New York Hospital- Cornell University Medical Center, 10021, USA.
Carew
J F
JF
Victor
J D
JD
Heise
C W
CW
Levine
J
J
D002528:Cerebellar Neoplasms / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000601:surgery*; D004558:Electric Stimulation; D005154:Facial Nerve / Q000502:physiology*; D006801:Humans; D008579:Meningioma / Q000601:surgery*; D016343:Monitoring, Intraoperative / Q000379:methods*; D009464:Neuroma, Acoustic / Q000601:surgery*; D011237:Predictive Value of Tests; D012189:Retrospective Studies