PRESERVATION OF FACIAL NERVE FUNCTION DURING CEREBELLOPONTINE ANGLE SURGERY: A DESCRIPTIVE CASE SERIES

Abstract

Objectives: This study aims to evaluate the importance of Facial nerve identification and accurate extra-arachnoidal resection during CPA tumor surgery with and without intraoperative facial nerve monitoring on postoperative facial nerve functions. Methodology: Our retrospective case series was conducted on ten patients operated upon for various CPA tumors from January 2023 to December 2023. All the patients had intact facial nerve functions preoperatively. MR imaging was undertaken preoperatively for all the cases to predict the location of the Facial nerve. In 2 cases, IFNM was used, while extra arachnoidal excision was performed in all the patients to preserve the facial nerve. All the patients were followed postoperatively with examination of the facial nerve and grading according to the House-Brackman (HB) grading system. Results: Due to all the perioperative cautionary measures and accurate intraoperative dissection, 80% of patients had intact facial nerves postoperatively, and 20% developed grade 2 facial palsy. Near-total removal was achieved in 8 patients, while only subtotal excision was possible in 2 cases. Conclusion: Facial nerve function can be preserved during CPA surgery with preoperative planning and meticulous surgical techniques, which are of particular importance to the seventh cranial nerve.