Facial nerve recovery following acoustic neuroma surgery.

A series of 76 consecutive patients undergoing unilateral acoustic neuroma excision is reported. Preoperative facial weaknesses and a tumour larger than 2.5 cm were predictive factors of poor facial nerve recovery, re-emphasising the need to detect and remove these tumours at an early stage. Electroneuronography performed around one week after surgery appears to be a good indicator of the likelihood of recovery in facial nerves which are anatomically intact, but which show no function at that stage. Multiple rehabilitative procedures are often required when inadequate function or poor cosmetic results are obtained. Primary nerve repair or facial-hypoglossal anastomosis provide better rehabilitative results than dynamic and static procedures.