Management of facial nerve in surgical treatment of previously untreated fisch class C tympanojugular paragangliomas: long-term results.
The aim of this study was to evaluate the long-term facial nerve outcome according to management of the facial nerve in patients undergoing surgery for Fisch class C tympanojugular paragangliomas. The study population consisted of 122 patients. The infratemporal type A approach was the most common surgical procedure. The facial nerve was left in place in 2 (1.6%) of the 122 patients, anteriorly rerouted in 97 (79.5%), anteriorly rerouted with segmental resection of the epineurium in 7 (5.7%), and sacrificed and reconstructed in 15 (12.3%). One patient underwent cross-face nerve grafting. At last follow-up, House-Brackmann grade I to II was achieved in 51.5% of patients who underwent anterior rerouting and in 28.5% of those who underwent anterior rerouting with resection of the epineurium. A House-Brackmann grade III was achieved in 73.3% of patients who underwent cable nerve graft interposition. The two patients in whom the facial nerve was left in place experienced grade I and grade III, respectively. The patient who underwent cross-face nerve grafting had grade III. Gross total resection was achieved in 105 cases (86%). Management of the facial nerve in tympanojugular paraganglioma surgery can be expected to ensure satisfactory facial function long-term outcome.
Department of Clinical and Experimental Medicine, Otolaryngology Unit, University-Hospital of Parma, Parma, Italy.
Andrea
A
Bacciu
Department of Otolaryngology, Hôpital Bachir Mentouri, Kouba, Algeria.
Hassan
H
Ait Mimoune
Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy.
Flavia
F
D'Orazio
Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy.
Francesca
F
Vitullo
Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy.
Alessandra
A
Russo
Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy.
Mario
M
Sanna
anterior rerouting; facial nerve; glomus tumor; tympanojugular paraganglioma