Facial nerve neuroma in the geniculate ganglion extending into the internal auditory canal: A case report

Auris Nasus Larynx. 2018 Jun;45(3):648-652. doi: 10.1016/j.anl.2017.09.010. Epub 2017 Oct 5.

Abstract

Facial nerve schwannoma is a very rare benign tumor representing less than 1% of intrapetrous lesions. Our patient is a forty-one year old female who has suffered from recurrent right facial palsy for the last six years. She was first misdiagnosed as having Bell's palsy and received corticosteroids which resulted in little improvement. She then had facial nerve decompression surgery which resulted in a partial improvement. Since then, she has suffered from recurrent attacks of facial palsy. Two years ago, she came to our hospital seeking further treatment options. The final diagnosis made by MRI was a possible facial nerve tumor. To obtain a better facial outcome, total tumor removal was performed through the middle cranial fossa approach along with facial-hypoglossal nerve end-to-side anastomosis through transmastoid approach. Her hearing was preserved, and she obtained a better facial outcome than that of her preoperative level. In conclusion, facial nerve schwannoma has the potential to be misdiagnosed as Bell's palsy which might lead to a delay in diagnosis, and end-to-side neurorrhaphy may be an effective alternative in a selected case.

Keywords: End to side facial-hypoglossal anastomosis; Facial nerve tumor; Middle cranial fossa.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Audiometry, Pure-Tone
  • Cranial Nerve Neoplasms / diagnostic imaging
  • Cranial Nerve Neoplasms / pathology
  • Cranial Nerve Neoplasms / surgery*
  • Facial Nerve Diseases / diagnostic imaging
  • Facial Nerve Diseases / pathology
  • Facial Nerve Diseases / surgery*
  • Female
  • Geniculate Ganglion / diagnostic imaging
  • Geniculate Ganglion / pathology
  • Geniculate Ganglion / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Neuroma / diagnostic imaging
  • Neuroma / pathology
  • Neuroma / surgery*
  • Tomography, X-Ray Computed