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Intrinsic facial nerve tumours of the temporal bone: a proposed management guideline

Published online by Cambridge University Press:  17 March 2015

G J Watson  and
R M Irving
G J Watson*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham, UK
R M Irving
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham, UK
*
Address for correspondence: Mr G J Watson, Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham B15 2TH, UK E-mail: glen_watson74@yahoo.co.uk
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Abstract

Objective:

The aim of this paper was to propose a guideline for the management of intrinsic facial nerve tumours based on our practice and findings in the literature.

Method:

A retrospective review of intrinsic facial nerve tumours over the last 15 years was performed. Parameters measured included age, presenting symptoms, pre- and post-treatment hearing and House–Brackmann grading, tumour position, treatment and duration of follow up.

Results:

A total of 15 patients presented with intrinsic facial nerve tumours over the study period. The most common presenting complaint was facial symptoms (93.3 per cent), followed by hearing loss (46.7 per cent). Three patients with stable facial nerve function (House–Brackmann grades II–III) were treated conservatively. Twelve patients underwent surgery to treat progressive or recurrent symptoms. Facial function was maintained or improved in 60.0 per cent of patients and hearing was preserved in 66.7 per cent.

Conclusion:

We propose that all stable tumours associated with good facial function of grade III or below should be treated conservatively. For symptomatic or progressive lesions, tailored surgery depending on the tumour site and hearing level should be offered to preserve native nerve function and facial musculature. For patients with prolonged paralysis, tumours can be monitored and other forms of facial reanimation and support offered.

Keywords

Facial NerveNeoplasm, BenignParalysisGuideline
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 5 , May 2015 , pp. 445 - 449
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented as a podium talk at the British Skull Base Society Meeting, London, 30–31 January 2014

References

1Saito, H, Baxter, A. Undiagnosed intratemporal facial nerve neurilemomas. Arch Otolaryngol 1972;95:415–9CrossRefGoogle ScholarPubMed
2Pulec, JL. Facial nerve neuroma. Ear Nose Throat J 1994;73:721–2, 725–39, 743–52CrossRefGoogle ScholarPubMed
3Shirazi, MA, Leonetti, JP, Marzo, SJ, Anderson, DE. Surgical management of facial neuromas: lessons learned. Otol Neurotol 2007;28:958–63CrossRefGoogle ScholarPubMed
4Kim, CS, Chang, SO, Oh, SH, Ahn, SH, Hwang, CH, Lee, HJ. Management of intratemporal facial nerve schwannoma. Otol Neurotol 2003;24:312–16CrossRefGoogle ScholarPubMed
5McMonagle, B, Al-Sanosi, A, Croxson, G, Fagan, P. Facial schwannoma: results of a large case series and review. J Laryngol Otol 2008;122:1139–50CrossRefGoogle ScholarPubMed
6Liu, R, Fagan, P. Facial nerve schwannoma: surgical excision versus conservative management. Ann Otol Rhinol Laryngol 2001;110:1025–9CrossRefGoogle ScholarPubMed
7Angeli, SI, Brackmann, DE. Is surgical excision of facial nerve schwannomas always indicated? Otolaryngol Head Neck Surg 1997;117:S144–7CrossRefGoogle ScholarPubMed
8Falcioni, M, Russo, A, Taibah, A, Sanna, M. Facial nerve tumors. Otol Neurotol 2003;24:942–7CrossRefGoogle ScholarPubMed
9Samy, RN, Krishnamoorthy, K, Pensak, ML. Use of a novel ultrasonic surgical system for decompression of the facial nerve. Laryngoscope 2007;117:872–5CrossRefGoogle ScholarPubMed
10Wilkinson, EP, Hoa, M, Slattery, WH 3rd, Fayad, JN, Friedman, RA, Schwartz, MS et al. Evolution in the management of facial nerve schwannoma. Laryngoscope 2011;121:2065–74CrossRefGoogle ScholarPubMed
11Eby, TL, Fisch, U, Makek, MS. Facial nerve management in temporal bone hemangiomas. Am J Otol 1992;13:223–32Google ScholarPubMed
12Friedman, O, Neff, BA, Willcox, TO, Kenyon, LC, Sataloff, RT. Temporal bone hemangiomas involving the facial nerve. Otol Neurotol 2002;23:760–6CrossRefGoogle ScholarPubMed
13Isaacson, B, Telian, SA, McKeever, PE, Arts, HA. Hemangiomas of the geniculate ganglion. Otol Neurotol 2005;26:796–802CrossRefGoogle ScholarPubMed
14Nadeau, DP, Sataloff, RT. Fascicle preservation surgery for facial nerve neuromas involving the posterior cranial fossa. Otol Neurotol 2003;24:317–25CrossRefGoogle ScholarPubMed
15O'Donoghue, GM, Brackmann, DE, House, JW, Jackler, RK. Neuromas of the facial nerve. Am J Otol 1989;10:49–54Google ScholarPubMed
16Perez, R, Chen, JM, Nedzelski, JM. Intratemporal facial nerve schwannoma: a management dilemma. Otol Neurotol 2005;26:121–6CrossRefGoogle ScholarPubMed
17Rodrigues, SJ, Fagan, PA, Biggs, ND. Management of cystic facial neuromas: an alternative approach. Otol Neurotol 2004;25:183–5CrossRefGoogle ScholarPubMed
18Sataloff, RT, Frattali, MA, Myers, DL. Intracranial facial neuromas: total tumor removal with facial nerve preservation: a new surgical technique. Ear Nose Throat J 1995;74:244–6, 248–56CrossRefGoogle ScholarPubMed
19Semaan, MT, Slattery, WH, Brackmann, DE. Geniculate ganglion hemangiomas: clinical results and long-term follow-up. Otol Neurotol 2010;31:665–70CrossRefGoogle ScholarPubMed
20Sherman, JD, Dagnew, E, Pensak, ML, van Loveren, HR, Tew, JM Jr.Facial nerve neuromas: report of 10 cases and review of the literature. Neurosurgery 2002;50:450–6Google ScholarPubMed
21Dai, C, Li, J, Guo, L, Song, Z. Surgical experience of intratemporal facial nerve neurofibromas. Acta Otolaryngol 2013;133:893–6CrossRefGoogle ScholarPubMed
22Saleh, E, Achilli, V, Naguib, M, Taibah, AK, Russo, A, Sanna, M et al. Facial nerve neuromas: diagnosis and management. Am J Otol 1995;16:521–6Google ScholarPubMed
23Kida, Y, Yoshimoto, M, Hasegawa, T. Radiosurgery for facial schwannoma. J Neurosurg 2007;106:24–9CrossRefGoogle ScholarPubMed