Evaluation of the prognosis of facial paralysis after surgery of acoustic neurinoma by an early Hilger's test
Nottet, J.B.; Freyss, G.; Buffe, P.
Annales d'Oto-Laryngologie et de Chirurgie Cervico Faciale Bulletin de la Societe d'Oto-Laryngologie des Hopitaux de Paris 108(4): 197-203
1991
ISSN/ISBN: 0003-438X PMID: 1854143 Document Number: 369962
Surgery for acoustic neuroma is highly risky for the facial nerve. This is why we have tried to assess immediate postoperative facial impairment by performing Hilger's test within the first few hours. Further evolution of the facial function showed the predictive value of Hilger's test as regards facial recovery. Indeed, a difference greater than 2 mA as compared with the opposite side indicates a lack of facial recovery at the 3rd postoperative month. In addition, facial muscle testing performed within the first postoperative 72 hours makes the prognosis of facial function recovery possible. Lack of facial recovery at the 3rd postoperative month was observed for neuromas with a diameter exceeding 2 cm. Preoperative assessment of the risk of facial sequellae is fundamental and essentially depends on the size of the tumor and on the surgical approach. Intraoperative facial monitoring allows better ensuring the preservation of the VIIth cranial nerve and consequently improves postoperative function.