ACOUSTIC NEUROMA SURGERY AND DELAYED FACIAL PALSY

Delayed onset of facial palsy is possibly an underestimated but distre ssing complication of acoustic neuroma surgery. The incidence of this complication reported in the literature has varied from 11.7 to 41%. T his study reviewed retrospectively 60 primary acoustic neuroma surgeri es performed by a single neurotologist. The delayed onset of facial dy sfunction was defined according to the guidelines described by of Lalw ani Butt, Jackler, Pitts and Jingling in 1995. They considered either a deterioration of facial function from normal to abnormal or an incre ased severity of the degree of facial paralysis, which was grouped usi ng the House-Brackmann scale system. Fifteen of the 60 patients (25%) were found to have a deterioration of facial function. The incidence o f delayed facial palsy was not influenced by age, sex or tumor size. T he majority of the patients had a favorable prognosis Only three patie nts had a grade III-IV facial function at 1 year. It is possible that these latter cases might have benefited from intraoperative meatal fac ial nerve decompression, as advocated by Sargent, Kartush and Graham.