Facial paralysis after acoustic neuroma surgery is most common in two situations

After acoustic neuroma surgery, some people often experience facial paralysis due to improper surgical operation. So, what will happen to facial paralysis after acoustic neuroma surgery?

(I) Facial paralysis with preserved facial nerve anatomy during surgery:

That is, the structure of the facial nerve remains intact and its continuity is not interrupted during the operation, and facial paralysis occurs due to mechanical stimulation of the facial nerve during the operation. At present, for giant acoustic neuromas, the highest record of facial nerve anatomical preservation rate internationally is 92% by Professor Samii, a master of neurosurgery in Germany; the domestic rate is about 80%; for these patients, active facial muscle exercises (persisting in raising forehead wrinkles, frowning, closing eyes, baring teeth, puffing cheeks, etc. in the morning, noon and evening), passive massage, kneading, physical therapy and acupuncture should be used to promote the recovery of facial paralysis. Most patients' facial paralysis will recover to varying degrees within six months after surgery. However, if facial paralysis has not recovered within half a year, facial nerve anastomosis (facial-hypoglossal nerve anastomosis or facial-accessory nerve anastomosis) should be considered, because the effect of nerve anastomosis is inversely proportional to the duration of facial paralysis, and the earlier the anastomosis, the better the effect; conversely, the later the anastomosis, the worse the effect.

(ii) No anatomical preservation of the facial nerve during surgery:

That is, if the facial nerve is ruptured during the operation, or even if the facial nerve is removed together with the tumor, the possibility of facial paralysis recovering on its own is very small, and nerve anastomosis should be performed as soon as possible without hesitation.