Surgical experience of intratemporal facial nerve neurofibromas

Abstract

Facial palsy was the first presentation in 10 cases, with repetitive facial palsy and vertigo in 1 case; 6 cases (54.5%) were insidious and 5 (45.5%) were sudden in terms of onset. Ear pain around the onset of facial palsy was found in four cases (36.4%). The tumor involved more than one segment in six cases. Among the non-grafted cases one patient with grade V facial nerve function recovered to grade III and another patient with grade VI facial nerve function recovered to grade IV, whereas only one case with grade VI recovered to grade IV among the grafted cases.

Clinical characteristics and outcomes of intratemporal facial nerve neurofibromas

“…In our study, all patients firstly presented with facial palsy, and sensorineural hearing loss appeared in merely one case. Similarly, in Dai C et al's [6] report, 10 of 11 cases were admitted due to facial palsy and one case complained of recurrent facial palsy and vertigo. It seemed that facial palsy was the predominant manifestation of intratemporal FNN and hearing loss or vertigo was rare.…”

“…Intratemporal FNN are benign tumors, and there haven't been any malignant cases reported before, possibly due to their rarity [1][2][3][4][5][6], although malignant transformation occurs in up to 15% of cases with neurofibromatosis type I [7].…”

Neurofibroma around the Ear Canal: Report of Three Cases

“…Ultimately, excisional biopsy is the gold standard for neurofibromas [9,10] . Dai et al [8] reported that for 54% of the patients in their study, more than one segment of the facial nerve was affected. They performed a transmastoid approach in all cases and used sural or auricularis magnus nerve grafts in four of the cases [8] .…”

“…It seems that the status of the facial function depends on the involvement of the facial nerve segment with the neurofibroma. Dai et al [8] reported that hearing loss, pulsatile tinnitus, and facial paralysis are common symptoms in intratemporal neurofibromas. Facial paralysis is generally not observed in an intraparotid neurofibroma, unlike with a facial nerve schwannoma [9] .…”

Long-term outcomes of facial nerve schwannomas with favorable facial nerve function: tumor growth rate is correlated with initial tumor size

“…Complete tumor removal with nerve integrity preserved is an interesting approach, which has been described by certain authors [5,[16][17][18][19], but there haven't been definite conclusion about whether such an approach could obtain better outcomes than nerve grafting for those cases who have Grade IV or worse. In addition, the requirements of surgical skills are quite high, if preservation of nerve integrity is considered.…”