These features are in contrast to neurofibromas, which are nonencapsulated and tend to engulf axons. 5 Computed tomograms often reveal an enhancing soft tissue mass, most frequently involving the geniculate ganglion. However, all segments of the facial nerve, from the internal auditory canal to the stylomastoid foramen, can be involved. Whereas computed tomograms will show canal enlargement in the middle ear and bony erosion of the inner ear, magnetic resonance images with gadolinium enhancement will more accurately assess intracranial or periparotid expansion. 6 Treatment is aimed at complete removal of the tumor mass, with surgical approach dictated by radiological assessment and degree of hearing loss.
Resection often necessitates a cable graft for reconstruction of the nerve.
While a House-Brackmann grade 3 or worse is to be expected, O'Donoghue and colleagues 3 correlated ultimate facial nerve function to the duration of preoperative paralysis, with longer preoperative paralysis leading to worse outcome. Schmidt C. Neurinom des Nervus facialis. Neuromas of the facial nerve. Am J Otol. Tumors of the Head and Neck.