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ORIGINAL ARTICLE
Year : 2017  |  Volume : 33  |  Issue : 2  |  Page : 484-489

Surgical management of the facial nerve in various skull base pathologies through different lateral skull base approaches


Department of Otorhinolaryngology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

Correspondence Address:
Ahmed A Omran
57 Safia Zaghloul Street, El Ramel Station, Alexandria - 21521
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1012-5574.206015

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Objective The aim of the present study was to demonstrate facial nerve (FN) outcomes in various skull base pathologies managed through different lateral skull base approaches. Materials and methods This retrospective study was conducted on 20 patients admitted to the ENT outpatient clinic of a tertiary referral center. All patients presented with different skull base lesions with or without FN involvement. A full preoperative assessment was carried out, including the House–Brackmann (HB) FN grading scale. Surgical techniques used to manage the FN depended on the surgical approach and the extent of the pathological lesion in the form of FN identification and monitoring, decompression, intact fallopian bridge technique, rerouting, anastomosis, or scarification. FN functional integrity was assessed 1 month and 1 year postoperatively using the House–Brackmann scale to assess different surgical techniques used to manage the FN and their effects on postoperative FN function. Results Half of the patients had glomus jugulare tumor, which were mostly managed through infratemporal fossa type A approach. At 1 month postoperatively, no great improvement was found in FN function in most of the cases. After 1 year, the improvement was statistically significant. Conclusion One year postoperatively could give idea of the FN surgical outcome. Grade III was the best result achieved in cases of FN grafting and anastomosis. In the present study, FN intact techniques were the most useful to yield better results than were grafting and anastomosis when the circumstances and extension of the pathology allow the surgeon to use such techniques.


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