The co-occurrence graph of high-frequency keywords in Chinese and English is shown in Figures 5, 6, after setting the time slice to 1, node type to keyword, and frequency threshold to the Top 50. Both English and Chinese studies focused on acoustic neuroma, facial nerve, facial palsy, and surgery. Table 4 shows the top ten keywords in both English and Chinese.

It is generally accepted that a Q value > 0.3 indicates a significant clustering result, while an S value > 0.5 is considered to represent reasonable clustering in keyword analysis. The Q and S values of the Chinese and English studies were 0.877 and 0.961, and 0.836 and 0.953, respectively, indicating that the cluster analysis was efficient and convincing. The smaller the cluster tag value, the more keywords it contains. The cluster analysis mapping of high-frequency keywords related to facial nerve injury and CPA tumors in Chinese and English studies is shown in Figures 7, 8, respectively.

CiteSpace uses emerging words to reflect trends in the field (20). There were two breakout terms, “neuroendoscopy” and “treatment outcome,” that persisted to the present when the γ value was set to 1 in Chinese literature. A total of 39 breakout terms appeared, with 7 of the 25 most emergent mutation terms persisting to the present, namely “risk,” “Guillain-Barré syndrome,” “magnetic resonance imaging,” “case report,” “identification,” “risk factors,” and “tools.” Figures 9, 10 present the keyword mutation maps in English and Chinese, respectively.

The facial nerve is mainly responsible for the movement of facial muscles and some sensory and glandular functions, playing an important role in facial expression, taste, and glandular secretion (26). It is crucial for patients that an appropriate assessment tool be selected to accurately evaluate facial nerve function and extend of damage, which may improve treatment selection and outcomes as well as patient prognosis. The main methods used to assess facial nerve function include the House-Brackmann (H-B) Facial Function Rating Scale (27), Burres-Fisch Facial Nerve Scoring System (28), Sunnybrook Facial Nerve Rating Scale (29), Facial Nerve Function Evaluation System (30), and Quantitative Rating Scale for Facial Palsy Symptoms and Signs and so on (31). All the above scales can be used to easily and quickly assess facial nerve function and recovery in a clinical environment. The H-B Scale can be widely used in the clinic as it allows a rapid assessment and facilitates the comparison of data between different institutions. Despite all these advantages, this scale focuses only on facial muscle movement and does not adequately reflect facial nerve function. The Burres-Fisch Facial Nerve Score encompasses multiple facial movements but is susceptible to user bias. The Sunnybrook Facial Nerve Rating Scale is indicated for evaluating a wide range of facial nerve dysfunctions. The Facial Nerve Function Scoring System includes a statistical and dynamic view, and can be more objective, comprehensive, accurate, and universally applicable than the Sunnybrook System. The Quantitative Facial Palsy Symptoms and Signs Rating Scale, which covers the signs and symptoms of the facial nerve, is more complex than other rating systems and can take longer times and its results are more dependent on the assessor’s experience. With the gradual maturation of artificial intelligence (AI) technology, several AI-based facial nerve function assessment systems have been developed. The eFace, a comprehensive facial function scoring system proposed by American researchers, has been widely used (32). Existing facial nerve function assessment tools primarily focus on the motor function of the facial nerve and pay less attention to sensory and glandular secretory function. Therefore, these tools cannot comprehensively and accurately assess the degree of facial nerve damage in patients. A comprehensive assessment of facial nerve function can be developed and implemented with the help of an AI system when conditions are favorable. Meanwhile, clinical nurses need to closely monitor postoperative facial nerve function in patients with CPA tumors to identify the early occurrence of facial paralysis as a pre-sentinel symptom. This can, in turn, help them carry out functional rehabilitation training through methods such as facial muscle exercises or acupuncture.

The facial nerve plays a crucial role in various physiological functions, including motor coordination, sensory perception, and parasympathetic control. Additionally, it is more susceptible to irreversible damage or even adverse outcomes, such as facial paralysis, during surgical resection of CPA tumors (26). The consequences of this injury extend beyond the physical realm and into the psychological realm, with patients facing not only a tangible loss of facial activity but also the profound challenge of impaired social expression (33). Therefore, existing studies have shifted from maximizing tumor resection and control to reducing postoperative neurological deficits by introducing intraoperative measures such as electrophysiological monitoring (24) and magnetic resonance imaging (34), especially for the facial and auditory nerves. Zhang et al. (35) used diffusion tensor imaging (DTI) preoperatively to predict the anatomical relationship between the facial nerve and vestibular schwannoma. Moreover, they protected the facial nerve intraoperatively under the guidance of neurophysiological monitoring, which reduced the risk of intraoperative facial nerve injury and improved the preservation of facial nerve function and the patients’ postoperative quality of life. However, 16 to 25% of patients still present with facial paralysis after surgery (14, 36). If patients do not undergo timely rehabilitation during the optimal recovery period following facial paralysis, or fail to regain normal facial nerve function within 12 months, the probability of long-term facial paralysis will remain high (37, 38). In severe cases, facial Synkinesis may emerge. Although there is limited research on how to help patients with facial nerve injuries rehabilitate and promote nerve function recovery. Fortunately, some studies have shown (39) that early rehabilitation can be facilitated by a multidisciplinary team using physical measures such as mirror therapy (40) or virtual reality technology (41) under the guidance of a physical therapist or rehabilitation technician. A quantity of evidences (42–44) suggests that patients with moderate or severe facial injuries exhibit higher levels of social impairment, poorer health ratings, and lower quality of life. This is supported by Keishi Fujiwara et al. (45), whose study showed that the quality of life of nearly half of the facial paralysis patients were severely compromised, particularly in terms of facial comfort and eye comfort. Thus, appropriate referral and systematic follow-up evaluations are essential components of symptom management. However, there are fewer studies on social participation, mental health, and quality of life in facial nerve injury patients in the field of nursing, which have not caused the widespread concern among researchers (8, 46, 47). This suggests that healthcare workers should consider the lower quality of life and poorer mental health of patients while assessing the degree of postoperative facial nerve injury in clinical work and scientific research.