Facial nerve outcome in lateral skull base surgery for benign lesions.

Abstract

To statistically identify factors most important in affecting CN7 outcome in lateral skull base surgery for benign lesions. A retrospective review of 217 nonmalignancy lateral skull base procedures from 1970 to 1995 at the Otology Group in Nashville. Charts were reviewed for epidemiology, histopathology, staging, type of CN7 mobilization (none, short, long, severance with reanastomosis, and resection), preoperative and postoperative CN7 function, surgery performed, and survival. Average House-Brackman (HB) scores for mobilizations were as follows: short, 1.65: long, 2.74: and grafting, 4.33. Factors found to affect outcome in a statistically significant fashion were preoperative HB score, staging, type of CN7 manipulation, and surgical approach. Meningiomas were found to have a worse outcome than glomus tumors. Complete resection of tumors should be performed with minimal manipulation of the facial nerve based on regional anatomy and tumor anatomy.