Analysis of facial nerve function preservation after vestibular schwannoma resection (literature review)

The purpose of this study was to provide a comprehensive assessment of the reported results of facial nerve preservation after vestibular schwannoma surgery. Materials and methods. Data on surgical access, tumor size, patient age, and use of intraoperative monitoring were extracted and correlated with facial nerve function after surgery. "Facial nerve preservation" was defined as grade I or II House-Brackman function at the last follow-up visit. Results. Patients operated by access through the middle cranial fossa tended to have a higher overall level of facial nerve preservation (85%) compared with translabirint access (81%, p = 0.07) and statistically better than retrosigmoid access (78%, p < 0.0001). Patients with an average tumor size < 20 mm had significantly higher rates of facial nerve preservation compared with larger tumors (90% vs. 67%, p < 0.0001). In patients under the age of 65, facial nerve preservation was lower (71% vs. 84%, p < 0.001). Finally, the use of intraoperative monitoring improved the safety of the facial nerve (76% vs. 71%, p < 0.001). Conclusion. Factors related to the preservation of the facial nerve after microsurgical resection of vestibular schwannoma included tumor size <20 mm, the use of access through the middle cranial fossa, and the use of neuromonitoring during surgery