Surgical Treatment of Intratemporal Facial Nerve Tumors

Purpose: To report the management, surgical procedure and outcomes from a case series of intratemporal facialnerve tumors. The management of patients with intratemporal tumors of the facial nerve has progressively evolved from performing microsurgical excision with restoration of the facial nerve to more conservative techniques aiming at preserving the integrity of the facial nerve. Methods: Sixteen patients with facial nerve tumors underwent surgery. The surgical approach was proposedafter a first phase of expectant management with careful observation of symptoms evolution. After tumor removal, a facio-facial nerve suture was performed in three cases. For the other cases, an intermediate graft from the great auricular nerve or the sural nerve was used. Results: A direct neurorrhaphy and plastics with intermediate graft allowed improvement of the facial functionby one grade on the House-Brackmann scale. During the observation period, which covered on average 10 months (+/- 5 months), tumor recurrence was not detected in any of the 16 patients. This was confirmed by post-surgical MRI examination. Conclusions: In spite of the fact that this pathology is quite rare, it is a priority disease because of its importantsocial and functional meaning. Paresis and mimic muscles paralysis is a great tragedy for a patient, and in this case the priority is to safe facial nerve functions. The efficiency of surgical treatment of facial nerve’s tumor and its functions’ restoration directly depends on its timely definition based on modern radiologic examination, prevalence rate of tumor’s stage and time duration of paresis.