The effect of famciclovir on delayed facial paralysis after acoustic tumor resection

Derald E Brackmann; Laurel M Fisher; Marlan Hansen; Andrea Halim; William H Slattery

doi:10.1097/mlg.0b013e3181788d5d

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The effect of famciclovir on delayed facial paralysis after acoustic tumor resection

Journal article

Peer reviewed

The effect of famciclovir on delayed facial paralysis after acoustic tumor resection

Derald E Brackmann, Laurel M Fisher, Marlan Hansen, Andrea Halim and William H Slattery

The Laryngoscope, Vol.118(9), pp.1617-1620

09/2008

DOI: 10.1097/mlg.0b013e3181788d5d

PMID: 18596563

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Abstract

To determine the efficacy of prophylactic famciclovir to significantly reduce the percentage of patients experiencing postoperative delayed facial paresis. Prospective evaluation of facial nerve grade for two groups (treated and untreated) with famciclovir before and after surgery. All procedures were conducted by the same group of experienced neurotologists. In a tertiary neurotologic private practice, the percentage of 1,023 patients with delayed facial paresis after undergoing microsurgical removal of unilateral acoustic tumor with no preoperative treatment was compared to the percentage of 530 patients with preoperative famciclovir treatment. Patients were prescribed famciclovir 500 mg BID for 3 days before surgery and 5 days postoperative. The House-Brackmann Facial Nerve Grade was assessed prospectively at preoperative, immediate postoperative, and discharge from the hospital in both groups. Twenty-five percent of the no famciclovir group experienced delayed facial palsy compared to 20% in the famciclovir group, a statistically significant difference (P < .04). The famciclovir group undergoing translabyrinthine craniotomy showed a significantly greater decrease in percentage of patients with delayed facial palsy than those undergoing middle fossa craniotomies (P < .003). Famciclovir administered preoperatively and after craniotomies resulted in a smaller percentage of patients developing delayed facial weakness. We are continuing the routine use of famciclovir in perioperative acoustic tumor management and recommend that others do so.

Prodrugs

Prospective Studies

Drug Administration Schedule

Follow-Up Studies

Antiviral Agents - therapeutic use

Cochlear Nerve

Humans

Middle Aged

2-Aminopurine - therapeutic use

Male

Treatment Outcome

Cranial Nerve Neoplasms - surgery

Antiviral Agents - administration & dosage

Facial Paralysis - prevention & control

Dose-Response Relationship, Drug

Time Factors

Cranial Nerve Neoplasms - complications

2-Aminopurine - analogs & derivatives

Craniotomy - methods

Female

Microsurgery - methods

2-Aminopurine - administration & dosage

Facial Paralysis - etiology

Details

Title: Subtitle: The effect of famciclovir on delayed facial paralysis after acoustic tumor resection
Creators: Derald E Brackmann - House Ear Institute, House Ear Clinic, Los Angeles, California 90057, USA
Laurel M Fisher
Marlan Hansen
Andrea Halim
William H Slattery
Resource Type: Journal article
Publication Details: The Laryngoscope, Vol.118(9), pp.1617-1620
Publisher: United States
DOI: 10.1097/mlg.0b013e3181788d5d
PMID: 18596563
ISSN: 0023-852X
eISSN: 1531-4995
Language: English
Date published: 09/2008
Academic Unit: Molecular Physiology and Biophysics; Neurosurgery; Otolaryngology
Record Identifier: 9984006437002771

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23 Times Cited - Web of Science