Intratemporal Traumatic Facial Nerve Neuromas in the Absence of Trauma

Objectives: To describe four patients with traumatic neuromas of the intratemporal facial nerve in the absence of trauma.

Design: Retrospective case series.

Setting: Tertiary care medical center.

Participants: Patients undergoing resection of a presumed facial nerve schwannoma with concurrent facial nerve grafting.

Results: Four patients are described who underwent complete resection of a presumed facial nerve schwannoma. Three tumors involved the tympanic and vertical segments of the facial nerve, and one tumor was present in the internal auditory canal. Pathologic evaluations, including immunohistochemistry, of the excised masses were consistent with traumatic neuromas. All tumors were noted to have a disorganized collection of axons and were not consistent with the expected diagnosis of schwannoma. These patients had no history of trauma or preceding chronic inflammatory process of the middle ear or mastoid.

Conclusions: Traumatic neuromas are possible in the intratemporal facial nerve in the absence of trauma. The etiology of this process could be related to aberrant regeneration of the facial nerve after an acute facial palsy such as Bell’s palsy.