Analysis of Preoperative Factors Influencing Hypoglossal-facial ‘Side’-to-side Neurorrhaphy for Facial Paralysis after Excision of Acoustic Neuroma

Abstract

ObjectiveHypoglossal nerve-facial nerve ‘side’-to-side neurorrhaphy is a new method for the treatment of potential incomplete facial paralysis after acoustic neuroma. However, there are differences in postoperative outcomes among patients. This study analysed preoperative factors that may influence the treatment outcomes of neurorrhaphy. MethodsWe performed a retrospective study of 53 patients who were treated by neurorrhaphy for facial paralysis after acoustic neuroma resection. After a one-year follow-up period, the patients were divided into two groups according to facial functional outcome: better recovery or ordinary recovery. We analysed the following factors: gender, age, tumour size, and characteristics, tumour adhesion to the facial nerve, the duration of facial paralysis (DFP) and F wave appearance prior to neurorrhaphy (F wave). ResultsUnivariate analysis showed significant differences between the two groups in DFP (P = 0.0002), tumour adhesion to the facial nerve (P = 0.0079) and F waves (P = 0.0048). Logistic regression analysis of these factors also showed statistical significance with P values of 0.042 for the DFP, 0.043 for F waves, and 0.031 for tumour adhesion to the facial nerve. ConclusionsTumour adhesion to the facial nerve, F waves appearance and DFP prior to neurorrhaphy are the predominant factors that influence treatment outcomes.