[The diagnosis and treatment of primary tumors of facial nerve: a report of 14 cases].

OBJECTIVE: To summarize the clinic characteristics of the tumors of facial nerve and discuss the diagnosis and treatment. METHODS: Fourteen cases of primary facial nerve tumors confirmed pathologically and treated in the Chinese PLA General Hospital from 1986-2000 were reviewed. The clinic manifestation, diagnosis and treatment in this series were analyzed. RESULTS: Among the 14 cases, there were 9 of facial neurilemmoma, 3 of facial neurofibroma and 2 of facial nerve hemangioma. The commonest first symptom was facial paralysis (10/14), the next was hearing loss(6/10). The commonest sign was the facial paralysis. The following was tumor in tympanic cavity (5/14) and the next was tumor in external auditory canal(4/14). The tumors in all 14 cases were totally resected surgically. The function of the facial nerve was normal in one case with nerve being preserved intact during operation, and in grade II in one case and grade III in other one case with nerves being preserved partly continuous. Facial--great auricular-facial nerve cable grafting were done in 6 cases, as result their facial nerve were in grade II in 2 cases, grade III in 3 case and grade IV in 1 case. The facial-lateral femoral cutaneous-facial nerve cable grafting was done in one case, and the facial nerve function was in grade III with 6 years of following-up. The second-stage facial-hypoglossal nerve anastomosis was done in one case, and the facial function consequently recover to grade II with 3 years of following-up. Three cases of facial nerve remained discontinuity and their facial nerve function showed no recovery (in grade VI). CONCLUSIONS: Once the facial nerve tumors were diagnosed, the surgical treatment should be done as early as possible. At the same time of tumor resection, the continuity of facial nerve should be kept and reconstructed in one stage as possible as we can, otherwise the second-stage surgery have be conducted soon after.