{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T21:25:32Z","timestamp":1781299532050,"version":"3.54.1"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Delayed facial palsy (DFP) is a common and unique complication after resection of vestibular schwannoma (VS). Few studies have focused on the clinical question of whether patients with DFP can be expected to have the same long-term prognosis in terms of facial nerve function as those without DFP based on their facial nerve function immediately postoperatively. This study aimed to clarify the clinical impact of DFP on the long-term functional status of the facial nerve after VS resection.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed patients with sporadic VS who were treated surgically via a retrosigmoid approach between January 2002 and March 2020. DFP was defined as de novo deterioration of facial nerve function by a House-Brackmann (HB) grade \u2265 I more than 72 hours postoperatively. The incidence of DFP after VS resection and its impact on long-term facial nerve function were analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>DFP developed in 38 (14.3%) of 266 patients who met the inclusion criteria. The median latency until DFP onset postoperatively was 8.5 days. When facial nerve function was normal immediately postoperatively, the rate of preservation of favorable facial nerve function (HB grade I or II) at 24 months postoperatively was 100% for all patients regardless of whether they developed DFP. In contrast, when facial nerve dysfunction was present immediately postoperatively, the rate of preservation of favorable facial nerve function at 24 months postoperatively was significantly lower in patients with DFP than in those without DFP (77.8% vs 100% in patients with HB grade II immediately postoperatively, p = 0.001; 50.0% vs 90.3% in those with HB grade III immediately postoperatively, p = 0.042). DFP development had a significantly negative impact on the long-term functional status of the facial nerve postoperatively when age, tumor size, and HB grade immediately postoperatively were taken into account (OR 0.04, 95% CI 0.01\u20130.20; p &lt; 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>DFP can be a minor complication when normal facial nerve function is observed immediately after surgery. However, when facial nerve dysfunction is present immediately after surgery, even if mild, the long-term prognosis for facial nerve function is significantly worse in patients with DFP than in those without DFP.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.10.jns231581","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T01:24:19Z","timestamp":1702689859000},"page":"1605-1613","source":"Crossref","is-referenced-by-count":9,"title":["Delayed facial palsy after resection of vestibular schwannoma: does it influence long-term facial nerve functional outcomes?"],"prefix":"10.3171","volume":"140","author":[{"given":"Yuichi","family":"Fujita","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Uozumi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Akutsu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo;"},{"name":"Department of Neurosurgery, Hyogo Prefectural Kobe Children\u2019s Hospital, Kobe, Hyogo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sasayama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Kohmura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo;"},{"name":"Department of Neurosurgery, Kinki Central Hospital, Itami, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"14","key":"b1","series-title":"N Engl J Med","first-page":"1335","article-title":"Vestibular schwannomas","volume":"384","author":"Carlson ML","year":"2021","unstructured":"Carlson ML, Link MJ. Vestibular schwannomas. N Engl J Med. 2021;384(14):1335\u20131348."},{"issue":"4","key":"b2","series-title":"Neurol Med Chir (Tokyo)","first-page":"176","article-title":"Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation","volume":"46","author":"Seol HJ","year":"2006","unstructured":"Seol HJ, Kim CH, Park CK,  Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation. Neurol Med Chir (Tokyo). 2006;46(4):176\u2013181."},{"issue":"1","key":"b3","series-title":"Neuro Oncol","first-page":"31","article-title":"EANO guideline on the diagnosis and treatment of vestibular schwannoma","volume":"22","author":"Goldbrunner R","year":"2020","unstructured":"Goldbrunner R, Weller M, Regis J,  EANO guideline on the diagnosis and treatment of vestibular schwannoma. 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Frequency and prognosis of delayed facial palsy after microvascular decompression for hemifacial spasm. Acta Neurochir (Wien). 2006;148(8):839\u2013843."},{"issue":"3","key":"b36","series-title":"J Craniofac Surg","first-page":"781","article-title":"Delayed facial palsy after microvascular decompression for hemifacial spasm","volume":"27","author":"Hua Z","year":"2016","unstructured":"Hua Z, Da TY, Hui WX,  Delayed facial palsy after microvascular decompression for hemifacial spasm. J Craniofac Surg. 2016;27(3):781\u2013783."},{"issue":"2","key":"b37","series-title":"J Neurosurg","first-page":"299","article-title":"Delayed facial palsy after microvascular decompression for hemifacial spasm: friend or foe?","volume":"129","author":"Lee JM","year":"2018","unstructured":"Lee JM, Park HR, Choi YD,  Delayed facial palsy after microvascular decompression for hemifacial spasm: friend or foe?. 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