RECOVERY OF THE SUTURED FACIAL-NERVE AFTER REMOVAL OF ACOUSTIC NEUROMA IN PATIENTS WITH NEUROFIBROMATOSIS-2

THE AUTHORS COMPARED the long-term recovery of sutured facial nerves a fter the removal of 8 neurofibromatosis-2 (NF2)-associated and 22 non- NF2 acoustic neuromas. The patients were from a series of 270 patients operated on for an acoustic neuroma between 1979 and 1989. The assess ment was done with a modified House and Brackmann scale from video rec ordings. At least some facial movement or tone was achieved (Grade 5 o r better) in all but three patients, but in none was the recovery exce llent, The facial function, judged by the overall appearance in moveme nt, recovered less in patients with NF2 (P = 0.048); a moderately good recovery (Grade 3 or better) was seen in one patient of eight with NF 2, as compared with 13 of 22 with non-NF2. In conclusion, if the tumor cannot be peeled off easily from the facial nerve in patients with NF 2, leaving a fragment of tumor behind is preferable to cutting and sut uring the facial nerve.