Atypical Tumours of the Intratemporal Facial Nerve: A Review Pages 34-43

Silvia Carolina Almeida Sandes1, Aline Gomes Bittencourt2, Rafael da Costa Monsanto1, Natal José Bobato Neto1, Fabio Tadeu Moura Lorenzetti2 and Raquel Salomone2

1ENT Department, Banco de Olhos de Sorocaba Hospital, Sorocaba, Brazil; 2Department of Otolaryngology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil and ENT Department, Banco de Olhos de Sorocaba Hospital (HOS-BOS), Sorocaba, Brazil

DOI: http://dx.doi.org/10.12970/2308-7978.2014.02.02.5

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Abstract: Objectives: To describe the characteristic of tumours that affect the facial nerve and discuss the most prevalent signs and symptoms, clinical presentations, diagnostic features and therapeutic approach to such tumours.

Study Selection: Studies published between 2002 and 2013, referring to atypical tumours of the facial nerve. We excluded studies that contained only patients with schwannoma of the facial nerve, as well as those that did not report the number of patients treated.

Data Synthesis: 22 studies reported 99 patients with tumours of the facial nerve. The most prevalent symptoms were facial palsy (99%), tinnitus (12.1%), and ear pain (6.1%). Surgical excision of the tumour was performed in 99% of patients, and the most common approach was via the middle cranial fossa (30.3%). The degree of facial palsy after resection of the tumour remained unchanged in 23.2% of patients; 19.2% improved and 2% deteriorated.

Conclusions: The cardinal symptom for the diagnosis of tumours of the facial nerve was facial palsy. Treatment involves surgical removal of the tumour with or without the use of grafts for reconstruction of the facial nerve. Other adjuvant therapies such as radiosurgery and facial nerve decompression are not yet established and require further research.

Keywords: Tumours, facial nerve, schwannoma, haemangiomas, neurofibromas, paragangliomas. Read more →