Prognostic Value of the Blink Reflex in Acoustic Neuroma Surgery

Abstract

Statistical analysis shows that the blink reflex, through DeltaR1, has an excellent prognostic value in anticipating the difficulties with facial nerve dissection and postoperative facial function after 1 year.

Vestibular Schwannoma Surgery Outcomes: Our Multidisciplinary Experience in 400 Cases Over 17 Years

“…23 We formerly reported the poor prognostic factor of the disappearance or lengthening of R1 response blink reflex latency on electrophysiological testing of the facial nerve. 24 The approach is thought to play a role in the preservation of the facial nerve: 25 TLA could allow a better localization of the nerve at the end of IAM, unlike WRLA. This was not confirmed by the present results.…”

Prognostic factors of Bell's palsy: Multivariate analysis of electrophysiological findings

“…28 In recent studies, BR findings were reported to be helpful for prognostic prediction in BP [41][42][43][44] and 1 year residua after acoustic neuroma surgery. 45 Latency of BR is delayed in neurapraxic lesions and absent precociously in recent onset axonotmesis ones. Specificity and sensitivity of this parameter at 5 to 7 days postonset are higher than EMG testing and increases with time.…”

Utility of preoperative electrophysiological testing of the facial nerve in patients with vestibular schwannoma

“…For example, Nagahiro et al observed a delay or absence of the R1 response in 91% of their series [16]. Darrouzet et al concluded that based on differences in the latency of the R1 responses of the affected and healthy sides, it is possible to predict dissection difficulties and postoperative facial muscles weakness, especially in cases where there is a lack of an ipsilateral R1 or differences exceeding 2 ms [4]. This is not consistent with our observations, but the R1 response was evaluated in a different way in our series.…”

“…However, outcome prediction using test results obtained prior to surgery is not yet possible, and the relevance of preoperative neurophysiological evaluation of CNVII function is not clear. For example, Darrouzet et al report that the changes in the preoperative blink reflex test correlate perfectly with difficulties in CNVII dissection and with postoperative facial muscles weakness [4]. However, van Dinther et al concluded that postoperative CNVII function cannot be predicted based on pre-operative neurophysiological testing [5].…”