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Corresponding Author

Mostafa Mohamed Saleh Ahmed Saif

Document Type

Original Article

Abstract

Background: The cerebellopontine angle (CPA) represents a region of intricate anatomical composition within the brain.

Aim: This study aimed to evaluate the effectiveness of various techniques in safeguarding the facial nerve during surgeries in the cerebellopontine angle region.

Methods: This retrospective and prospective study was carried out on 20 cases of CPA tumors. All cases underwent neurological examination (Brain stem compression signs, VII cranial nerve, based on the scale of House and Brackmann, VIII cranial nerve on both sides, V cranial nerve with its motor and sensory functions and IX, X, XI for bulbar palsy manifestations), and investigations (routine haematological investigations, pure Tone Audiometry, radiological investigations).

Results: Tumor size showed high accuracy AUC (AUC=0.907) for the prediction of facial nerve preservation. Best cut-off value and performance characteristics. Facial nerve preservation showed a significant negative correlation with tumor size (p=0.004). The negative correlation coefficient implies that as tumor size increases, the likelihood of facial nerve preservation decreases. Also, Tumors with Firm consistency were found to be a significant risk factor for non-preserved facial nerve (p < 0.001).

Conclusion: Functional preservation of facial nerve function after surgery can be achieved through several key approaches: predicting the facial nerve's position relative to the tumor before the operation, employing Intraoperative Neurophysiological Monitoring during surgery, and opting for subtotal or near-total tumor resection followed by radiosurgery when monitoring suggests a significant risk to the nerve's integrity.

Keywords

Cerebellopontine angle tumors; Facial Nerve Preservation; Intraoperative Neurophysiological Monitoring

Subject Area

Neurosurgery

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