Intracranial facial nerve neurinoma: surgical strategy of tumor removal and functional reconstruction.
BACKGROUND
Three cases with intracranial facial neurinoma underwent tumor removal and facial nerve reconstruction with or without tympanoplasty. Surgical strategy for each case was tailored to: (1) the site of main tumor mass, (2) its extension along the facial nerve, and (3) involvement of the auditory organs.


METHODS
Surgeries adopted in the three cases were: transpetrosal approach with intracranial-intratemporal facial nerve anastomosis, middle fossa and transmastoid approach with intratemporal facial nerve anstomosis and tympanoplasty, and middle fossa and transmastoid approach with intracranial-intratemporal facial nerve anastomosis and tympanoplasty. The greater auricular nerve was used as the nerve graft for all three cases.


RESULTS
In the follow-up period of 8-13 months there was no tumor recurrence; facial function was scored 20/90 in modified May's scoring system in each case, but two are still in the process of functional recovery. One of the two cases who underwent tympanoplasty showed complete recovery of hearing within 1 month, and the other showed worsened hearing, which was not serviceable at 3 months postoperatively.


CONCLUSIONS
Systematic surgical approach for tumor removal, facial nerve reconstruction, and auditory reconstruction should be considered in cases with intracranial facial neurinoma due to its varied clinical features.
Yamaki
T
T
Department of Neurosurgery, Sapporo Medical University School of Medicine, Japan.
Morimoto
S
S
Ohtaki
M
M
Sakatani
K
K
Sakai
J
J
Himi
T
T
Harabuchi
Y
Y
Tanabe
S
S
Hashi
K
K
D000368:Aged; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005154:Facial Nerve / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D014432:Tympanic Membrane / Q000601:surgery