The surgical management of facial nerve tumor

Purpose To improve the diagnosis and management of facial nerve tumor. Methods Eighteen patients with facial nerve tumor were retrospectively analyzed during 1993-2004.All patients were undergone either CT scan or MRI,or both.The period of follow-up varies from 6 months to 5 years (average 40 months).Facial nerve function was evaluated with House-Brackman(H-B) grading system. Results Totally 14 cases complained of facial paralysis,9 presented with hearing loss,2 seeked for medical care due to mass in external auditory canal,and 2 had mass in parotid gland.Image studies revealed mass located along the facial nerve course from the parotid gland to internal auditory meatus.Intraoperative findings showed mass involved in internal auditory meatus to parotid gland.Furthermore,mass involved in multiple segment of facial nerve in 12 cases.In 2 cases tumor was pearl-ball cluster along the facial nerve from the internal auditory canal to parotid gland.Postoperative pathological diagnosis demonstrated 14 Schwannoma,3 neurinoma and 1 case hemangioma.Seven patients were undergone facial nerve graft,2 recovered to H-B Ⅲ and the other 5 reached H-B Ⅳ,postoperatively.Facial nerve anastomosis was performed on 1 patient,and postoperative outcome was H-B Ⅳ.Two patients underwent tumor resection,while the continuity of facial nerve was preserved;their facial nerve function was H-B Ⅱ and H-B Ⅲ,respectively.One patient operated with facial nerve decompression recovered postoperative facial nerve function to H-B Ⅰ.No facial nerve reconstruction was done on other 7 patients. Conclusions The presentation of facial nerve tumor was various,multiple origins of facial nerve tumor were noted.Postoperative facial nerve function was associated with the surgical procedure and preoperative facial nerve function.