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Intrinsic facial nerve tumours of the temporal bone: a proposed management guideline

Published online by Cambridge University Press:  17 March 2015

G J Watson  and
R M Irving
G J Watson*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham, UK
R M Irving
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham, UK
*
Address for correspondence: Mr G J Watson, Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham B15 2TH, UK E-mail: [email protected]
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Abstract

Objective:

The aim of this paper was to propose a guideline for the management of intrinsic facial nerve tumours based on our practice and findings in the literature.

Method:

A retrospective review of intrinsic facial nerve tumours over the last 15 years was performed. Parameters measured included age, presenting symptoms, pre- and post-treatment hearing and House–Brackmann grading, tumour position, treatment and duration of follow up.

Results:

A total of 15 patients presented with intrinsic facial nerve tumours over the study period. The most common presenting complaint was facial symptoms (93.3 per cent), followed by hearing loss (46.7 per cent). Three patients with stable facial nerve function (House–Brackmann grades II–III) were treated conservatively. Twelve patients underwent surgery to treat progressive or recurrent symptoms. Facial function was maintained or improved in 60.0 per cent of patients and hearing was preserved in 66.7 per cent.

Conclusion:

We propose that all stable tumours associated with good facial function of grade III or below should be treated conservatively. For symptomatic or progressive lesions, tailored surgery depending on the tumour site and hearing level should be offered to preserve native nerve function and facial musculature. For patients with prolonged paralysis, tumours can be monitored and other forms of facial reanimation and support offered.

Keywords

Facial NerveNeoplasm, BenignParalysisGuideline
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 5 , May 2015 , pp. 445 - 449
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented as a podium talk at the British Skull Base Society Meeting, London, 30–31 January 2014

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