Predictors of Facial Nerve Dysfunction by Time of Discharge Following Vestibular Schwannoma Resection

Introduction: Facial nerve (FN) preservation is a critical consideration in vestibular schwannoma resection, as dysfunction can substantially impair patient quality of life. While long-term FN outcomes are important, early postoperative function at the time of discharge is also clinically meaningful. FN status at discharge reflects the patient’s initial recovery trajectory, influences the need for rehabilitation services, and informs patient and family counseling during the immediate postoperative period. Identifying predictors of FN dysfunction at discharge may therefore provide valuable insights for surgical planning and perioperative management. We investigated predictors of FN dysfunction at discharge following vestibular schwannoma resection. Methods: We retrospectively reviewed patients who underwent vestibular schwannoma resection at a large urban tertiary care center between 2004 and 2024. FN function was graded using the House-Brackmann (HB) scale at discharge. Moderate FN dysfunction was defined as HB III or IV while severe FN dysfunction was HB V or VI. Demographic, clinical, and tumor characteristics were compared between FN dysfunction groups using appropriate parametric and non-parametric tests. Variables with p6 months prior to resection compared to those with higher HB grades (40.7% vs 16.1–21.0%; p