Complications

Complication
Timeframe
Likelihood
short term
medium

Hearing loss occurs at a higher rate with larger tumours and with poor pre-treatment hearing level.

Occurs as immediate loss at time of surgery with no recovery.

Preservation rate very dependent on tumour size and configuration, and surgeon clinical expertise.

Tinnitus is difficult to predict; patients may lose all hearing and still have persistent symptoms.[67]

short term
low

Most patients have some very mild weakness immediately after surgery with good recovery over weeks to months.

Often associated with some altered tear production and taste, although these will recover.

Rarely, patients may exhibit complete weakness with recovery over months to a year; in such cases often only partial recovery with persistent asymmetry occurs.

May need to consider reconstruction of facial function if no recovery with plastic surgery for facial function and ophthalmological surgery for eyelid closure.

Can be a significant problem if eye does not close well, especially if associated with facial or eye numbness.

Facial nerve preservation rate is very dependent on size and configuration of tumour and surgeon expertise.[65][66][92][93]

short term
low

Often improves early if affected preoperatively.

If additional facial weakness occurs, and patient is unable to close eye, with decreased tear production and anaesthetic cornea, patient cannot adequately detect a foreign body.

Significant recovery expected, but may not recover completely.

short term
low

In the early postoperative period, cerebrospinal fluid leaks can occur through the wound or sometimes through passageways in the bone out of the nose, requiring lumbar drain or rarely surgical repair.

long term
low

Radiation is known to rarely cause secondary malignancies. It occurs at a low rate of <1 in 1000 patients, often many years after the treatment.[91]

long term
low

Hydrocephalus is a known complication of radiation treatments, thought to be caused by an increase in cerebrospinal fluid protein. A ventriculoperitoneal shunt may be necessary to manage post-radiation hydrocephalus.

variable
medium

Hearing can be lost despite stability of tumour(s) on scans.

Hearing preservation depends on level of pre-treatment hearing, size of tumour, and surgeon experience.[89]

May vary from 20 to 30 dB to complete loss.

Tinnitus difficult to predict; patients may lose all hearing and still have persistent symptoms.

No curative treatment is possible.[60]

Cochlear implants may be used in select cases.

variable
low

Radiation injury to the facial nerve may rarely cause facial palsy and may be associated with dryness of the ipsilateral eye and altered taste sensation.[90]

Recovery usually occurs over many months with conservative management.[62]

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