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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2019; 80(01): e10-e13
DOI: 10.1055/s-0039-1685212
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Expansile Traumatic Neuroma of the Intratemporal Facial Nerve

Yening Feng
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Neil S. Patel
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Anthony M. Burrows
2   Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
John I. Lane
3   Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States
,
Aditya Raghunathan
4   Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States
,
Jamie J. Van Gompel
2   Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Matthew L. Carlson
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Further Information

Publication History

22 August 2018

16 October 2018

Publication Date:
01 April 2019 (online)

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Abstract

Objectives To present a rare case of traumatic facial neuroma involving the geniculate ganglion and review relevant literature.

Patient Thirty-year-old man.

Intervention Microsurgical resection via combined mastoid-middle fossa approach with great auricular nerve interpositional graft.

Main Outcome Measures Patient demographics and pre- and postoperative facial nerve function.

Results A 30-year-old man with a reported history of prior Bell's palsy developed progressive complete (House–Brackmann VI) right facial paralysis following blunt trauma. Imaging was strongly suggestive of a geniculate ganglion hemangioma. As the patient had no spontaneous improvement in his poor facial function over the course of 9 months, he underwent resection of the facial nerve lesion with great auricular nerve graft interposition via a combined mastoid-middle fossa approach. Histopathology demonstrated disorganized fascicles, with axonal clustering reminiscent of sprouting/regeneration following trauma. No cellular proliferation or vascular malformation was present.

Conclusion Traumatic facial nerve neuromas can occur following temporal bone trauma and can closely mimic primary facial nerve tumors. Akin to the management of geniculate ganglion hemangioma and schwannoma, preoperative facial function largely dictates if and when surgery should be pursued.

Keywords

facial nerve - traumatic neuroma - facial nerve schwannoma - geniculate - hemangioma
 

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