title: Need for facial reanimation after operations for vestibular schwannoma: patients perspective.
abstract: A total of 779 patients operated on for vestibular schwannoma mostly by the translabyrinthine approach in Denmark during the period 1976-2000 answered a questionnaire about various postoperative consequences. In this paper we describe the patients' facial function evaluated by professionals one year postoperatively and self-evaluated by each patient according to the House-Brackmann scale at the time of the questionnaire. The patients' self-evaluation was more pessimistic than that of the professionals with 26% reporting House-Brackmann grade IV-VI, compared with 20%. One hundred and seventeen (15%) of 779 patients considered their facial palsy to be a big problem and 125 patients (16%) were interested in surgical treatment for the sequelae of facial palsy. Seventy-eight (10%) had already had some kind of operation, usually the VII-XII coaptation. Thirty-three of 61 patients who had already been operated on for facial palsy were interested in further surgical treatment. One hundred and ninety-five patients (25%) had some kind of operation on the eye, mostly (88%) a tarsorrhaphy. Reanimation procedures such as a palpebral gold weight or a spring, apparently still have a small place in Denmark. In conclusion, there seem to be a considerable and unmet need for surgical reanimation of facial function in patients with facial palsy after operations for vestibular schwannoma in Denmark.
authors.affiliation: Department of Oto-rhino-laryngology, Head and Neck Surgery, Gentofte University Hospital of Copenhagen, Hellerup, Denmark. tinatos@dadlnet.dk
authors.forename: Tina
authors.initials: T
authors.lastname: Tos
authors.forename: Per
authors.initials: P
authors.lastname: Caye-Thomasen
authors.forename: Sven-Eric
authors.initials: SE
authors.lastname: Stangerup
authors.forename: Jens
authors.initials: J
authors.lastname: Thomsen
authors.forename: Mirko
authors.initials: M
authors.lastname: Tos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001828:Body Image; D003718:Denmark; D005154:Facial Nerve / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000209:etiology* / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000601:surgery*