Facial Nerve Outcomes Following Malignant Lateral Skull Base Surgery at a Tertiary Centre

Abstract Background Although a rare malignancy, lateral skull base tumours often present a challenge to head and neck surgeons due to complex neurovascular anatomy. Patients also tend to present late with advanced disease. With lateral skull base tumours being a rare occurrence, there is limited knowledge on facial nerve outcomes following surgery. Method Data from 44 patients were collected and analysed. The main outcome collected in this study was facial nerve function at presentation and post op (both immediately and long-term) according to the House-Brackmann scale. Results 90% of patients presented without signs and symptoms of facial nerve involvement. Patients who had no facial pain or paralysis at presentation are more likely to maintain normal facial functions after surgery (20 out of 26 that scored House-Brackmann 1 pre-op maintain a score of 1 in long term post-op review). 80% of those who presented with signs and symptoms of facial nerve involvement required intraoperative nerve sacrifice. Conclusions Patients who presented with facial pain or paralysis tend to have more advanced disease. The majority (80%) of those presenting with facial deficits pre-operatively underwent nerve sacrifice. The purpose of this study is to offer insight into facial nerve outcomes of patients who underwent lateral skull base surgery at a tertiary centre. We collected and analysed the outcomes of surgery for 44 patients, with main outcome measures including facial nerve functions based on the House-Brackmann scale, as well as any postoperative complications, recurrences, types of adjuvant therapy required and survival after the operation.