Pre‑ and intra‑operative prognostic factors of facial nerve function in cerebellopontine angle surgery

Emilio Amilibia Cabeza*, Francesco Gazia, Angela Callejo Castillo, Marta Pérez-Grau, Susana Lareo, Jose Prades, Francesc Roca-Ribas

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)


PURPOSE: The study assesses whether pre- and intraoperative factors linked to electromyography and direct electrical stimulation (DES) of facial nerve can predict facial nerve function in the short- (12 days) and long-term (1 year) after cerebellopontine angle (CPA) tumor resection.

METHODS: 157 patients who underwent surgical resection of CPA tumors with facial nerve monitoring. Pre-operative factors (age, tumor size, pure tone average), surgical time and intra-operative parameters regarding facial function, minimum stimulation threshold (MST), compound muscle action potential (CMAP) and the difference between proximal and distal CMAP (DPDC) were evaluated.

RESULTS: A correlation between tumor size, MST, CMAP and facial function in both short and long term was found. A higher grade of immediate facial paralysis corresponded to a higher risk of poor outcome after one year. A postoperative House-Brackmann (HB) score of V or VI was correlated with poor outcome in 88.8% and 93.8% of cases. A risk of HB 3 or more, in the long term, was correlated with a tumor size of 20.2 mm. Using an MST of 0.1 mA, for long-term predictions, sensitivity and specificity were 0.62 (95% CI 0.46-0.75) and 0.73 (95% CI 0.61-0.82), respectively. With a CMAP cut-off < 200 µV, for long-term prediction, sensitivity was 0.73 (95% CI 0.53-0.87) and specificity 0.73 (95% CI 0.55-0.85).

CONCLUSION: The assessment based on the cut-offs described increases the ability to predict facial function. Improving predictive accuracy enables surgeons to address patients' expectations and to establish an intervention timeline for planning facial reanimation.

Translated title of the contributionFactores pronóstico pre- y intraoperatorios de la función del nervio facial en la cirugía del ángulo pontocerebeloso
Original languageEnglish
Number of pages8
JournalEuropean Archives of Oto-Rhino-Laryngology
Early online date30 Jul 2022
Publication statusPublished - 30 Jul 2022


Dive into the research topics of 'Pre‑ and intra‑operative prognostic factors of facial nerve function in cerebellopontine angle surgery'. Together they form a unique fingerprint.

Cite this