Risk factors of secondary temporary facial nerve palsy after vestibular schwannoma resection

Introduction The occurrence of facial paralysis is one of the main risks after vestibular schwannoma (VS) resection. The aim of this study is to identify predictive factors that may indicate the occurrence of secondary temporary facial paralysis.

Material and methods A retrospective analysis of n=193 patients (pat.) after VS resection in domo from 2012-2022 was performed. N=134 pat. were included, of which n=20 pat. had secondary facial paresis (House-Brackmann score of 2-5), and pat. with direct postoperative paresis were excluded. A binomial regression analysis was performed to evaluate the influence of age, gender, KOOS classification, access route (retrosig. vs. translab.) and postop. liquorrhea with regard to the occurrence of secondary facial nerve palsy. The regression model was statistically significant, χ²(6) = 23.69, p <.001.

Results Pat. with secondary temporary facial nerve palsy (w:11/20, m:9/20) have a mean age of 53.51 years, all grades of KOOS classification are represented. A KOOS grade ≥ 2 shows a statistically significant higher risk (OR 10.9 95% CI [3.334-43.21; p = 0.0001) for the occurrence of secondary temporary facial nerve palsy. Postoperative liquorrhea appears to be an additional risk factor (OR 4.37 95% CI [0.827-22.92]; p = 0.074), but statistically only a trend can be described. 3-12 months after therapy, 95% of pat. have a HB score of 1-2.

Summary In summary, the mentioned parameters could be demonstrated as risk factors for the occurrence of secondary temporary facial nerve palsy. In the future, these aspects should also be part of patient education and therapy planning.

Publication History

Article published online:
12 May 2023