Long-term prognosis of profound facial nerve paralysis secondary to acoustic neuroma resection

The long-term prognosis of profound facial nerve paralysis was reviewed in 107 patients who, despite preserved nerve continuity, showed no facial move ment after acoustic neuroma resection. Spontaneous recovery occurred in 77 patients. However, there was no apparent recovery in 30 patients. Twenty-tw o of these patients underwent hypoglossal-facial nerve anastomosis 7-33 mon ths after tumor resection, When spontaneous recovery occurred, the first si gn of remission was observed between 3 and 4 months after surgery in nearly half of the patients. Such a sign did not appear after 12 months. The reco very of facial movement deteriorated depending on how long remission onset was delayed. However, the quality of facial movement in patients with such delayed remission was still identical or better than that in those after hy poglossal-facial nerve anastomosis. These results showed that hypoglossal-f acial nerve anastomosis should be performed approximately 1 year after tumo r resection if no sign of remission has been observed by then.