Cataract Associated with Long-Term Facial Paralysis

Goren, Seymour B.

doi:10.1016/0002-9394(75)90150-6

Cited by 1 publication

(3 citation statements)

References 2 publications

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“…Rates of corneal dysesthesia or facial dysesthesia are between 20% and 50% prior to VS surgery; 22,31,45,46 and up to 70% in larger tumors (with an extrameatal diameter >4 cm). 47 V nerve outcomes following VS surgery are less commonly reported than VII nerve outcomes. When reported, the rates of corneal or facial hypoesthesia after VS resection vary widely between 2% and 40%.…”

Section: Trigeminal (V) Nerve Damagementioning

confidence: 98%

“…When reported, the rates of corneal or facial hypoesthesia after VS resection vary widely between 2% and 40%. 16 , 22 , 34 , 46 , 48 It is difficult to determine whether V nerve damage in these reports arose from the effects of the tumor or the effect of surgery. Whilst VII nerve function is clearly adversely affected by VS surgery, V nerve function may be more affected by the tumor itself over and above the surgery.…”

Section: Trigeminal (V) Nerve Damagementioning

confidence: 99%

“…71 The visual fields may be affected in a variety of ways ranging from an enlarged blind spot (not usually a hindrance to the patient) through to extensive loss of peripheral and/or central fields and blindness. 72,73 Papilledema at the time of presentation with VSs is relatively uncommon, but with large tumors (>4cm) it may be present in up to 20% of cases, 22,47 and papilledema with or without visual dysfunction can be the presenting feature of a VS. 5,74 Where there is evidence of visual dysfunction (for example, transient visual obscurations, visual field changes and reduced visual acuity), then care needs to be taken to preserve vision, and management may involve urgent CSF drainage via an external ventricular drain or optic nerve sheath fenestration prior to resection of the tumor. 5 If papilledema occurs following VS resection, with or without other symptoms, then a cerebral venous sinus thrombosis needs to be excluded.…”

Section: Papilledemamentioning

confidence: 99%

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Neuro-Ophthalmic Complications of Vestibular Schwannoma Resection: Current Perspectives

Chiu¹,

Hickman²,

Pepper³

et al. 2021

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Vestibular schwannomas (VSs), also called acoustic neuromas, are benign intracranial neoplasms of the vestibulocochlear (VIII) cranial nerve. Management options include “wait-and-scan,” stereotactic radiosurgery and surgical resection. Due to the proximity of the VIII nerve to the facial (VII) nerve in the cerebello-pontine angle, the VII nerve is particularly vulnerable to the effects of surgical resection. This can result in poor eye closure, lagophthalmos and resultant corneal exposure post VS resection. Additionally, compression from the tumor or resection can cause trigeminal (V) nerve damage and a desensate cornea. The combination of an exposed and desensate cornea puts the eye at risk of serious ocular complications including persistent epithelial defects, corneal ulceration, corneal vascularization, corneal melting and potential perforation. The abducens (VI) nerve can be affected by a large intracranial VS causing raised intracranial pressure (a false localizing sign) or as a result of damage to the VI nerve at the time of resection. Other types of neurogenic strabismus are rare and typically transient. Contralaterally beating nystagmus as a consequence of vestibular dysfunction is common post-operatively. This generally settles to pre-operative levels as central compensation occurs. Ipsilaterally beating nystagmus post-operatively should prompt investigation for post-operative cerebrovascular complications. Papilledema (and subsequent optic atrophy) can occur as a result of a large VS causing raised intracranial pressure. Where papilledema follows surgical resection of a VS, it can indicate that cerebral venous sinus thrombosis has occurred. Poor visual function following VS resection can result as a combination of all these potential complications and is more likely with larger tumors.

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