FASCIAL NERVE PRESERVATION IN CEREBELLOPONTINE ANGLE TUMORS SURGERIES

Abstract

Background: Impairment of the facial nerve functions, after cerebellopontine angle surgery is a common complication that limits the quality of life. Appropriate preoperative planning with a visualization of the facial nerve is a vital tool for the proper management of this disease. Objective: To discuss retrospectively and introspectively, the different modalities helping in preservation the facial nerve during cerebellopontine angle surgeries, and to evaluate the outcome of the usage of these modalities. Patients and Methods: A total of 30 cases with cerebellopontine angle lesions, who had surgical excision of these lesions, performed by different surgical procedure, with preservation of facial nerve function. They were operated upon in Neurosurgery Department at Al-Azhar University Hospitals and Nasser Institute Hospital, during the period between November 2017 and November 2019. Results: One patient had a CSF leak that was temporarily, one patient had postoperative hydrocephalus that was treated with external ventricular drain, and one patient had small sized intracranial hemorrhage resolved spontaneously and did not need any intervention. The remaining 27 patients have improvement of symptoms and signs at follow up periods of 3, 6, 12 months. Conclusion: Preservation of the facial nerve, during cerebellopontine angle surgeries, can be done altogether with total removal of the tumor in one session, by usage of microscopic surgical procedures altogether with intraoperative neurophysiological monitoring. Facial nerve preservation is a safe procedure.