Functional Rehabilitation of the Lower Cranial Nerves after Skull Base Surgery

Not only do lesions of the skull base involve the cranial nerves, surgical excision increases the risks to different cranial nerves. Although, the facial and cochlea vestibular nerves are the ones which are of major concern, lesions of the lower cranial nerves should also be addressed. Vagal affection usually results in changes in voice and aspiration with deglutition problems. Hypoglossal injury usually affects speech and deglutition. Accessory paralysis affects shoulder movement and can affect the patient's occupation. Rehabilitation should be preplanned or at least considered very shortly after the definitive management of the original lesion. A combination of surgical and rehabilitative programs can be instituted to prevent or at least minimize the resulting morbidity.