Post-operative Status of Facial Nerve in Cerebello-Pontine Angle Lesion via Retro-Sigmoid Approach; Complications and Outcome

  Objective:  To assess the post-operative status of Facial Nerve in cerebellopontine angle (CPA) lesion via retro-sigmoid approach and also its complications and outcome. Materials & Methods:  This prospective study was conducted at the Department of Neurosurgery, JPMC Karachi from a period of 10-12-2021 to 10-06-2022.The sample size of our study was 37 patients. All the patients were operated for CPA lesions and followed for three months to assess the outcome efficacy. Results:  Our study showed that the mean age was 37 years, with a range of 27 to 65 years, in which the males were 18 (48.6%) and the females were 19 (51.4%). Out of 37 patients, 28 (75.7%) were diagnosed with vestibular schwannoma, while 6 (16.2%) were meningiomas, and 3 (8.1%) were epidermoid cysts. Gross total resection was performed in 14 (37.8%) patients, while subtotal resection (STR) in 23 (62.2%). Facial nerve function in terms of House-Brackmann at 3 months was found to be grade I in 26 (70.3%), grade II in 9 (24.3%), grade III in 1 (2.7%), and grade IV in 1 (2.7%). Conclusion:  The CPA is a small corridor through which important neurovascular structures pass. Identification of CN VII is important in large CPA tumours to preserve facial motor nerve function.  For all kinds of CPA lesions, gross total excision should be the aim of surgery.