title: Evolution of Patients With Immediate Complete Facial Paralysis Secondary to Acoustic Neuroma Surgery.
abstract: OBJECTIVE
  To study the evolution of patients with immediate complete facial paralysis after acoustic neuroma surgery in different scenarios and assess different facial reanimations techniques.
  
  
  METHODS
  This study included 50 patients with complete facial paralysis immediately after acoustic neuroma surgery. Data were analyzed into 4 groups according to the need and type of reconstruction of the facial nerve, either none, immediate, or on a deferred basis. All patients had intraoperative facial nerve monitoring, and facial nerve function was evaluated according the House-Brackmann (HB) scale.
  
  
  RESULTS
  Of all patients with immediate total paralysis, no patients achieved totally normal facial function (grade I), and only 5 (10%) recovered to a grade II. For all groups included, the majority of patients (82%) achieved an acceptable final facial function (grade III HB). In this series, only 2 patients remained with a grade VI facial function.
  
  
  CONCLUSIONS
  The possibility of recovering near normal facial function after a grade VI facial paralysis is very low. Procedures like the immediate repair of the facial nerve with an interposed donor graft may provide better facial function in patients with partially injured facial nerve. Even in cases of total section, there are other procedures that can improve the results.
authors.affiliation: Department of Otolaryngology, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain pardoadriana833@gmail.com.
authors.forename: Adriana
authors.initials: A
authors.lastname: Pardo-Maza
authors.affiliation: Department of Otolaryngology, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Lassaletta
authors.affiliation: Department of Maxillofacial Surgery, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: González-Otero
authors.affiliation: Department of Neurosurgery, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Roda
authors.affiliation: Department of Phisical Therapy, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Moraleda
authors.affiliation: Department of Ophthalmology, Facial Paralysis Unit, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Arbizu
authors.affiliation: Department of Otolaryngology, La Paz University Hospital, IdiPaz Research Institute, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Gavilán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D015331:Cohort Studies; D018450:Disease Progression; D005154:Facial Nerve / Q000601:surgery; D020220:Facial Nerve Injuries / Q000209:etiology*; D005158:Facial Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009464:Neuroma, Acoustic / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D055815:Young Adult
keywords: facial reinnervation; hypoglosal-facial anastomosis; vestibular schwannoma