TITLE:
Clinical Benefits of Facial Nerve Monitoring during Cerebellopontine Angle Surgery
AUTHORS:
Ahmed A. Farag, Abd El-Kafy Sharaf El-Din Ibrahim, Islam M. Alaghory
KEYWORDS:
Facial Nerve, Monitoring, Cerebellopontine Angle, Retrosigmoid
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.1,
December
9,
2021
ABSTRACT: Background: The surgery of cerebellopontine angle tumours has remarkably progressed
over the last 2 decades due to improved microsurgical techniques. The primary operative goals are microscopic total
removal of the tumour while securing the adjacent cranial nerves. Facial
Nerve plays a critical role in facial muscles function and one’s cosmetic
appearance, and its weakness can have profound
implications on a patient’s quality of life. Aim of the Study: To assess the impact of monitoring techniques on the
preservation of facial nerve function during cerebellopontine angle
tumours surgery. Patients and Methods: This is a prospective study. This
study was conducted on 30 cases (2 groups, each
had 15 patients) with CPA lesions that had undergone surgical excision
of these lesions performed by retrosigmoid approach (Group A: the patients
were operated under continuous intraoperative facial nerve monitoring (IOFNM) and Group B: the patients were operated without IOFNM). They were operated upon in neurosurgery
departments at Al-Azhar university hospitals
between August 2019 and August 2021. Results: This study showed that excellent
facial nerve function (HB Grade I and II) was higher in group A than group B, immediately and at 6-month post op (80% and 93% VS 53.3%
and 66.7%). Intermediate (HB Grade III and VI) and Poor (HB Grade V and VI) facial nerve function was higher in group B
than group A; both immediately and 6-month postop (46.7% and 33.3% VS
20% and 6.6%). However, no statistically
significant P-Value between both groups. Conclusion: We concluded
that IOFNM can help, but cannot guarantee, the preservation of facial nerve. Furthermore, it is merely a technical
adjunct and does not replace surgical skills, knowledge of anatomy and
experience.