Nervus intermedius function after XXXX removal: clinical features and pathophysiological mechanisms.

@entity1 @entity735 @entity5513 @entity2103
The results of @entity2103 following @entity5513 removal have generally ignored the sensory component of the nerve. This lack of reporting occurs partly because the distress relating to these functions is less obvious to the surgeon, and partly because the @entity2103 grading systems currently used do not include the functions of the nervus intermedius. We have estimated the frequency and nature of abnormalities of nervus intermedius function following @entity5513 removal using a retrospective questionnaire. Questionnaires were mailed to 257 @entity1 and correctly completed and returned by 224 (87%) of the @entity1 . Prior to surgery 5 (2%) of the @entity1 complained of crocodile tears, 9 (4%) noted @entity735 (6%) complained of an abnormality of taste. Postoperative crocodile tears occurred in 98 (44%), an absence or significant reduction in the production of tears was noted in 162 (72%), and a taste abnormality, either a significant reduction or an alteration in character, was noted in 107 (48%). The onset of crocodile tears approximated to a bimodal distribution, and the recovery of nervus intermedius functions was variable. This study has demonstrated that nervus intermedius abnormalities are common following @entity5513 removal. It also documents their natural history and discusses the underlying pathophysiological mechanisms. We suggest that appropriate preoperative counseling be given to all @entity1 undergoing surgery and that the functions of the nervus intermedius be included in the surgical reporting of @entity2103 results in cerebellopontine angle surgery.
