안면신경 전방전위를 이용한 경정맥공 종양 제거 수술에서 술 후 안면신경 기능의 예후인자 분석

Prognostic factors for post-operative facial nerve function after removal of jugular foramen tumor with anterior facial nerve rerouting

Objectives : Resection of jugular foramen tumors is limited by the intratemporal course of the facial nerve. Facial nerve rerouting techniques were developed to facilitate resection of extensive tumors occupying the skull base. Although facial nerve rerouting technique can maximize the surgical view, it may result in some degree of facial nerve paresis. We have therefore analyzed factors associated with post-operative facial nerve outcome in patients with jugular foramen tumor who were undergone surgical management including anterior facial nerve rerouting. Study design : Retrospective study Methods : We retrospectively enrolled 21 patients with jugular foramen tumor who underwent anterior rerouting of the facial nerve. Rerouting technique, type of mastoidectomy, operation time, completeness of tumor resection and change of facial expression were obtained from the medical records. Facial nerve function was evaluated using House-Brackmann grading system. Results : Shorter rerouting resulted in a better outcome without statistical significance. Operation time lesser then 12 hours had a better facial nerve outcome at immediately postoperative evaluation. However, facial nerve outcome within 6-12 months did not show the difference. Conclusion : The facial nerve function at 12 months after operation could be preserved in 90.5 % of patients who underwent surgical management of the jugular foramen tumor including anterior rerouting of the facial nerve. We can expect better facial nerve outcome with short rerouting and after operation with short duration. The facial nerve should be minimally manipulated during even in the rerouting procedure.