Background The retro-sigmoid approach is a popular surgical method for excision of cerebellopontine angle tumors. The technique ensures appropriate exposure to the cerebellopontine angle while limiting brain retraction, preserving hearing, and allowing facial nerve detection. Nevertheless, one of the major disadvantages of this operation is facial nerve palsy. Objective To determine the frequency of facial nerve palsy after the retro-sigmoid approach for cerebellopontine angle tumors. Patients and methods This descriptive case series study was carried out at the Department of Neurosurgery, PIMS, Islamabad, for 6 months from August 10, 2022, to February 9, 2023. Patients aged 18–70 years of either sex diagnosed with cerebellopontine angle tumors were included. After taking informed written consent from all patients’, the operative procedure (retro-sigmoid approach) was performed as per hospital protocols. Patients were kept and followed in the ward postoperatively till considered fit to be discharged and the stay period was recorded on the Performa. Results Overall, 85 patients were studied, and out of these 37 (43.5%) were males while 48 (56.5%) were female patients, with an overall mean age of 49.48 ± 9.59 years. Out of all 21.2% (18 cases) were found to have facial nerve palsy, while the majority, 78.8% (67 cases), did not present with this condition. Facial nerve palsy was significantly more common in patients over 50 years of age (P = 0.001) and was strongly associated with diabetes and hypertension (P = 0.001 for both). There was no significant association with sex (P = 0.655) or obesity (P ≥ 0.05). Conclusion The retro-sigmoid approach for cerebellopontine angle tumors is observed to be a safe, reliable, and effective technique with a low frequency of facial nerve palsy. However, a more careful consideration should be given, particularly to patients with diabetes and hypertension, to achieve optimal outcomes.
Sharif et al. (Thu,) studied this question.