Subacute Facial Nerve Paralysis Following Cyberknife Treatment for Vestibular Schwannoma
Journal Title: Journal of Case Reports and Studies - Year 2018, Vol 6, Issue 1
Abstract
Facial nerve paralysis may occur along the natural progression of an untreated vestibular schwannoma, as a surgical complication following vestibular schwannoma resection, or as a late sequela of stereotactic radiation. However, facial paralysis occurring as a subacute complication of CyberKnife (Accuray, Inc., Sunnyvale, CA, USA) stereotactic radiation has not previously been reported. A 47-year-old male presented with a right vestibular schwannoma measuring 3.1 cm in greatest dimension with House-Brackmann grade I/VI facial function and American Academy of Otolaryngology – Head and Neck Surgery class a hearing. After deferring surgery, he elected to undergo CyberKnife stereotactic radiation to a total dose of 18 Gy in three stages. Within three months, the patient noticed gradual ipsilateral facial paralysis that progressed to House-Brackmann grade VI/VI over the course of four weeks. The patient’s facial function was assessed continuously for one year with no volitional function or resting tone. He thus underwent a hypoglossal-facial transfer, restoring facial function to House-Brackmann IV/VI, with durable results at a follow-up length of five years. To our knowledge, this is the first reported case of subacute facial paralysis following CyberKnife stereotactic radiation for vestibular schwannoma.
Authors and Affiliations
Johnson E
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- EP ID EP584733
- DOI 10.15744/2348-9820.6.103
- Views 79
- Downloads 0
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