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J Neurol Surg B Skull Base 2014; 75(01): 001-007
DOI: 10.1055/s-0033-1349061
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Management of Facial Nerve in Surgical Treatment of Previously Untreated Fisch Class C Tympanojugular Paragangliomas: Long-Term Results

Andrea Bacciu
1   Department of Clinical and Experimental Medicine, Otolaryngology Unit, University-Hospital of Parma, Parma, Italy
,
Hassan Ait Mimoune
2   Department of Otolaryngology, Hôpital Bachir Mentouri, Kouba, Algeria
,
Flavia D'Orazio
3   Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy
,
Francesca Vitullo
3   Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy
,
Alessandra Russo
3   Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy
,
Mario Sanna
3   Department of Oral and Nano-Biotechnological Sciences, Gruppo Otologico Piacenza-Rome and University of Chieti, Chieti, Italy
› Author Affiliations
Further Information

Publication History

08 April 2013

30 April 2013

Publication Date:
21 August 2013 (online)

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Abstract

The aim of this study was to evaluate the long-term facial nerve outcome according to management of the facial nerve in patients undergoing surgery for Fisch class C tympanojugular paragangliomas. The study population consisted of 122 patients. The infratemporal type A approach was the most common surgical procedure. The facial nerve was left in place in 2 (1.6%) of the 122 patients, anteriorly rerouted in 97 (79.5%), anteriorly rerouted with segmental resection of the epineurium in 7 (5.7%), and sacrificed and reconstructed in 15 (12.3%). One patient underwent cross-face nerve grafting. At last follow-up, House-Brackmann grade I to II was achieved in 51.5% of patients who underwent anterior rerouting and in 28.5% of those who underwent anterior rerouting with resection of the epineurium. A House-Brackmann grade III was achieved in 73.3% of patients who underwent cable nerve graft interposition. The two patients in whom the facial nerve was left in place experienced grade I and grade III, respectively. The patient who underwent cross-face nerve grafting had grade III. Gross total resection was achieved in 105 cases (86%). Management of the facial nerve in tympanojugular paraganglioma surgery can be expected to ensure satisfactory facial function long-term outcome.

Keywords

tympanojugular paraganglioma - glomus tumor - facial nerve - anterior rerouting
 

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