Association of Tumor Consistency with Functional Status of Facial Nerve Following Vestibular Schwannoma Surgery in Our Perspective

Background: Vestibular schwannomas are the most common cerebellopontine angle tumors, with variable intraoperative consistency that may influence facial nerve outcomes. This study aims to assess the association between tumor consistency and postoperative facial nerve function following vestibular schwannoma surgery. Aim of the study: The aim of the study was to evaluate the association between intraoperative tumor consistency and postoperative facial nerve functional status in patients undergoing vestibular schwannoma surgery. Methods: This experimental study at the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, and the National Institute of Neurosciences and Hospital, Dhaka (March 2018–September 2019), included 31 vestibular schwannoma patients. Data on demographics, preoperative T2 MRI intensity, intraoperative tumor consistency, extent of resection (postoperative CT), and facial nerve function (House-Brackmann grading) were collected. Tumor consistency was assessed by the chief surgeon. Data were analyzed with SPSS 23; p < 0.05 was significant. Results: Of the 31 patients, 58.1% had soft tumors and 41.9% had firm tumors. Gross total resection was significantly more common in soft tumors (83.3% vs. 23.1%, p = 0.001). Good facial nerve function improved from 77.4% on 3rd POD to 87.1% on 7th POD (p = 0.375), with no significant association between tumor consistency and facial outcome at either point (p = 1.000). Conclusion: Tumor consistency is significantly associated with the extent of tumor resection but not with immediate postoperative facial nerve function, and may serve as a useful preoperative indicator to guide surgical planning and patient counseling.