Facial nerve neuroma: diagnosis and management

Facial neuroma is a condition of insidious onset. Prior to the introduction of modern imaging techniques (computerised tomography, magnetic resonance imaging) delays between presentation and diagnosis were common place. Atypical facial paralysis and hearing loss are the most common presenting features. This combination is very suggestive of a facial neuroma and is an indication to proceed to computed tomography. This investigation can reveal expansion of the Fallopian canal at any point through the temporal bone. A few facial neuromas occur in the cerebello-pontine angle alone or in the parotid. Resection and grafting are always worthwhile as facial neurones seem to persist in the tumour mass keeping muscle alive until the facial nerve graft becomes functional. The presentation, management and results of treatment of 15 such cases is presented.