Complications
Hearing loss occurs at a higher rate with larger tumors and with poor pretreatment hearing level.
Occurs as immediate loss at time of surgery with no recovery.
Preservation rate very dependent on tumor size and configuration, and surgeon clinical expertise.
Tinnitus difficult to predict; patients may lose all hearing and still have persistent symptoms.[67]
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 ophthalmologic 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 tumor and on surgeon expertise.[65][66][92][93]
Often improves early if affected preoperatively.
If additional facial weakness occurs, and patient is unable to close eye, with decreased tear production and anesthetic cornea, patient cannot adequately detect a foreign body.
Significant recovery expected, but may not recover completely.
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.
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]
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 postradiation hydrocephalus.
Hearing can be lost despite stability of tumor(s) on scans.
Hearing preservation depends on level of pretreatment hearing, size of tumor, 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.
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