Facial Paraysis Caused by Neoplastic Lesions.

Facial paralysis caused by neoplastic lesions is relatively rare, but these patients have more serious consequences than those with other etiologies. In this study, we investigated 46 cases of facial paralysis caused by benign or malignant tumors and discuss the clinical features. The incidence of neoplastic facial paralysis was 3.4% (46/1350) and the rate of malignant tumors was 65.2% over all. Of the various kinds of tumors that led to facial paralysis, acoustic and facial neurinomas, carcinomas in the parotid gland and in the external auditory canal, leukemia and malignant lymphoma were the most frequent origins. It took more than 1 month after the onset of paralysis to identify the causative tumors in 12 patients, and 7 of them were misdiagnosed with Bell's palsy at the early stage of paralysis. A total of 21 of 34 patients developed an unusual course, such as progressive, non-recovered and remittent palsy, different from Bell's palsy and Ramsay-Hunt syndrome. Since the courses of paralysis were different in each patient in this study, we suggest that careful confirmation of the accompanied symptoms, such as continuing or worsening pain, hearing loss, otorrhea and other cranial nerve palsies, is important. The prognosis of malignant tumors was markedly poor and no patient survived for more than 5 years. Based on this study, we consider that in order to save patients' lives in cases of malignancies and to prevent facial paralysis in benign tumors, the diagnosis of the neoplastic lesions should be performed as soon as possible.