Immediate repair indicated. A mass in the parotid associated with facial paralysis is a sign of malignancy. In general, paralysis of immediate onset carries a poor prognosis and paralysis of delayed onset has a more favorable recovery. All paralysis should be followed with electrical testing, as exceptions to the maxim exist. Timely exploration and repair ensure better quality of return of function.
Facial nerve is examined via transmastoid, translabyrinthine approach in transverse fractures.
The primary tumor of the facial nerve per se is the facial neurinoma. Weakness of the face is the most common symptom. Treatment is surgical removal with grafting of the involved segment of nerve. Surgical removal is necessary in most cases. Radiation therapy may be palliative depending on cell type, size, and location.