{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:09:03Z","timestamp":1791374943825,"version":"4.3.1"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The object of this study was to evaluate long-term postoperative facial nerve (FN) function in patients undergoing vestibular schwannoma (VS) surgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors retrospectively reviewed the clinical course of patients affected by isolated VSs with normal preoperative FN function, with no previous surgical or radiotherapeutic treatment, and who underwent surgery between 1987 and 2007. Facial nerve function was clinically evaluated according to the House-Brackmann (HB) scale. The minimum postoperative follow-up was 12 months.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 1550 patients surgically treated at the authors' center, 1151 matched inclusion criteria for the present study. The FN was anatomically interrupted in 48 cases (4.2%), and 51 patients (4.4%) underwent subtotal tumor removal and were considered separately. Among the 1052 patients with anatomically preserved FNs and total tumor removal, 684 (65%) enjoyed postoperative HB Grade I or II and 309 (29.4%) enjoyed Grade III, with the remaining 59 cases (5.6%) suffering unsatisfactory results (HB Grades IV\u2013VI). As expected, FN function results deteriorated in cases of larger tumors.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The main factor influencing postoperative FN function was tumor size. Although there was a progressive deterioration in FN function outcome in relation to tumor size, a cutoff point between satisfactory and unsatisfactory results could be identified at around 2 cm in maximum extrameatal tumor diameter, with the \u201coptimal size\u201d for surgery identified at &lt; 1 cm. This finding emphasizes the importance of an early diagnosis and should be kept in mind when selecting the correct timing for VS removal. For small lesions, the results following a middle cranial fossa approach were significantly worse as compared with those following the translabyrinthine and retrosigmoidretrolabyrinthine approaches.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.5.jns101597","type":"journal-article","created":{"date-parts":[[2011,6,18]],"date-time":"2011-06-18T02:30:47Z","timestamp":1308364247000},"page":"820-826","source":"Crossref","is-referenced-by-count":128,"title":["Facial nerve function after vestibular schwannoma surgery"],"prefix":"10.3171","volume":"115","author":[{"given":"Maurizio","family":"Falcioni","sequence":"first","affiliation":[{"name":"Gruppo Otologico, Piacenza-Roma; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Fois","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Otoneurosurgery, University of Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelkader","family":"Taibah","sequence":"additional","affiliation":[{"name":"Gruppo Otologico, Piacenza-Roma; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Sanna","sequence":"additional","affiliation":[{"name":"Gruppo Otologico, Piacenza-Roma; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101597","series-title":"Arch Otolaryngol Head Neck Surg","first-page":"543","article-title":"Facial function in hearing preservation acoustic neuroma surgery","volume":"127","author":"Arriaga","year":"2001"},{"key":"b2-jns101597","series-title":"Am J Otolaryngol","first-page":"83","article-title":"Intracranial facial nerve grafting after removal of vestibular schwannoma","volume":"30","author":"Bacciu","year":"2009"},{"key":"b3-jns101597","series-title":"Otolaryngol Head Neck Surg","first-page":"104","article-title":"The fate of the tumor remnant after less-than-complete acoustic neuroma resection","volume":"130","author":"Bloch","year":"2004"},{"key":"b4-jns101597","series-title":"Otolaryngol Head Neck Surg","first-page":"773","article-title":"Facial nerve function after translabyrinthine vestibular schwannoma surgery","volume":"136","author":"Brackmann","year":"2007"},{"key":"b5-jns101597","series-title":"Laryngoscope","first-page":"1406","article-title":"The learning curve for acoustic tumor surgery","volume":"106","author":"Buchman","year":"1996"},{"key":"b6-jns101597","series-title":"Otol Neurotol","first-page":"384","article-title":"Cerebrospinal fluid leak after retrosigmoid excision of vestibular schwannomas","volume":"29","author":"Falcioni","year":"2008"},{"key":"b7-jns101597","series-title":"Otol Neurotol","first-page":"388","article-title":"Predictive factors of long-term facial nerve function after vestibular schwannoma surgery","volume":"23","author":"Fenton","year":"2002"},{"key":"b8-jns101597","series-title":"Otol Neurotol","first-page":"1076","article-title":"Revision surgery for residual or recurrent vestibular schwannoma","volume":"28","author":"Freeman","year":"2007"},{"key":"b9-jns101597","series-title":"Skull Base","first-page":"317","article-title":"What is the best tumor size to achieve optimal functional results in vestibular schwannoma surgery?","volume":"18","author":"Gjuric","year":"2008"},{"key":"b10-jns101597","series-title":"Otol Neurotol","first-page":"223","article-title":"Enlarged middle fossa vestibular schwannoma surgery: experience with 735 cases","volume":"22","author":"Gjuri\u0107","year":"2001"},{"key":"b11-jns101597","series-title":"Laryngoscope","first-page":"2014","article-title":"Comparison of postoperative facial nerve outcomes between translabyrinthine and retrosigmoid approaches in matched-pair patients","volume":"113","author":"Ho","year":"2003"},{"key":"b12-jns101597","series-title":"Otolaryngol Head Neck Surg","first-page":"146","article-title":"Facial nerve grading system","volume":"93","author":"House","year":"1985"},{"key":"b13-jns101597","series-title":"Arch Otolaryngol","first-page":"586","article-title":"Acoustic neuroma. 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