title: Predictive value of postoperative electrophysiologic testing of the facial nerve after cerebellopontine angle surgery.
abstract: Our objective was to assess the ability of postoperative electroneuronography (ENoG) and electromyography (EMG) to predict clinical facial function 1 year postoperatively in patients with facial paralysis and an intact facial nerve after cerebellopontine angle surgery. The study was a prospective, nonrandomized, uncontrolled clinical trial on an outpatient basis, at a tertiary care hospital. Primary eligibility criteria include: (1) cerebellopontine angle (CPA) surgery with anatomical preservation of facial nerve, (2) complete facial nerve paralysis; and (3) 1 year follow-up. ENoG and EMG were measured at 1 and 3 months postoperatively, House-Brackmann facial nerve grade at 1 year postoperatively. The Kendall coefficient of rank correlation demonstrated that the 1 and 3 month postoperative ENoG data were significant predictors of ultimate facial nerve outcome. Tracking multiple ENoG examinations in a single patient, over time was of little predictive value. EMG was a poor predictor of facial nerve outcome. In general, patients with delayed facial nerve paralysis had better ultimate facial function than patients with immediate paralysis. Postoperative ENoG, but not EMG was a statistically significant predictor of ultimate facial nerve outcome after CPA surgery. Patients with delayed facial paralysis had better outcomes than those with immediate facial paralysis.
authors.forename: S H
authors.initials: SH
authors.lastname: Selesnick
authors.forename: G P
authors.initials: GP
authors.lastname: Digoy
authors.forename: Y
authors.initials: Y
authors.lastname: Ptachewich
authors.forename: M
authors.initials: M
authors.lastname: Rubin
authors.forename: J D
authors.initials: JD
authors.lastname: Victor