Facial Nerve Tumors: Clinical Presentation and Surgical Results

Objective: The objective of this study was to describe differences in clinical presentations and to evaluate the long-term facial nerve (FN) function after surgery of facial nerve tumors. Methods: A total of 34 patients operated between 1991 and 2013 were included in this retrospective study. There were 20 men and 14 women, mean age of 41.2 years (range, 13-70). Eighteen schwannomas (52.9%), 14 hemangiomas (42.2%), and 2 meningiomas (5.9%) were studied. Results: Most of the patients had as revealing symptoms facial paralysis (n = 24; 70.6%), hearing loss (n = 7; 20.6%), vertigo (n = 18; 54%) or tinnitus (n = 8; 23.6%). Facial palsy revealed hemangiomas (n = 13; 92.9%), while schwannomas were revealed by both facial (n = 9; 50%) and cochleovestibular symptoms (n = 9; 50%). The facial palsy was also more severe in hemangiomas even small-sized: according to House-Brackmann scale, FN function was IV or more in 77% of hemangiomas and in 49% of schwannomas. One year after the surgery, the facial function according to House-Brackmann scale was II in 1 case (3.8%), III in 11 (42.3%), IV in 11 (42.3%), and 5 in 3 cases (11.5%). Conclusion: FNT are revealed by facial or cochleovestibular symptoms. Hemangiomas are more aggressive concerning facial function. Total excision is necessary if there is a significant facial palsy, with dissection of the nerve whenever possible, or reconstruction with graft.