안면신경 전방경로변경술후 안면신경의 기능 회복

Abstract

Background and Objectives：The transposition of the facial nerve is an essential procedure to obtain optimal surgical field and to remove the lesion completely when the tumor is located medial to the facial nerve. However, we frequently encounter postoperative facial palsy after transposition. The aim of the study is to find out how to treat the facial nerve in order to reduce the incidence and the degrees of postoperative facial palsy after anterior transposition of the facial nerve.

Material and Methods：Facial nerve function after anterior transposition of the facial nerve were analyzed retrospectively in 10 cases with skull base tumor using the House-BracKJCann grading system. The minimum follow-up period was 12 months.

Results：Favorable outcome was noted when the fallopian canal was exposed as widely as possible, and soft tissues were preserved at stylomastoid foramen. Postoperative facial palsy was recovered completely when the facial nerve was not involved by disease. The final House-BracKJCann grades were I, II, III in three cases in which tumor was involved with the facial nerve. The immediate postoperative function of the facial nerve is influenced by surgical procedure and surgeon’s skill, and the final status of the facial nerve function depends on the involvement of tumor in the nerve.

Conclusion：In order to obtain favorable postoperative facial nerve function, no attempt was made to dissect the facial nerve, and all the soft tissue that were attached to the facial nerve through the stylomastoid foramen were sharply elevated and traspositioned together with the facial nerve.