Advances in Facial Reanimation: Management of the Facial Nerve in the Setting of Vestibular Schwannoma

Purpose of Review: While vestibular schwannomas are benign in nature, their treatment carries risk of facial nerve injury. Facial palsy causes significant physical and psychological morbidity. This article focuses on contemporary recommendations for the management of facial palsy in the setting of vestibular schwannoma. Recent Findings: Approximately 5–15% of patients experience long-term facial palsy following resection of vestibular schwannoma. Facial reanimation should be considered in patients with facial paralysis without evidence of recovery by 6 months post-operatively. Treatment of facial paralysis aims at restoration of facial symmetry and reduction of functional morbidity through wide range of treatment methods, from static procedures and injectable treatments to nerve transfers and regional or free muscle transfers. Summary: Facial palsy is a dreaded complication of vestibular schwannoma extirpation. Many treatment options exist, and early referral to a facial nerve specialist should be offered to patients with facial palsy for prompt evaluation and treatment.