title: Facial nerve paralysis secondary to occult malignant neoplasms.
abstract: OBJECTIVE
  This study reviewed patients with unilateral facial paralysis and normal clinical and imaging findings who underwent diagnostic facial nerve exploration. Study design and setting Fifteen patients with facial paralysis and normal findings were seen in the Mayo Clinic Department of Otorhinolaryngology.
  
  
  RESULTS
  Eleven patients were misdiagnosed as having Bell palsy or idiopathic paralysis. Progressive facial paralysis with sequential involvement of adjacent facial nerve branches occurred in all 15 patients. Seven patients had a history of regional skin squamous cell carcinoma, 13 patients had surgical exploration to rule out a neoplastic process, and 2 patients had negative exploration. At last follow-up, 5 patients were alive.
  
  
  CONCLUSIONS
  Patients with facial paralysis and normal clinical and imaging findings should be considered for facial nerve exploration when the patient has a history of pain or regional skin cancer, involvement of other cranial nerves, and prolonged facial paralysis.
  
  
  CONCLUSIONS
  Occult malignancy of the facial nerve may cause unilateral facial paralysis in patients with normal clinical and imaging findings.
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Derek O
authors.initials: DO
authors.lastname: Boahene
authors.forename: Kerry D
authors.initials: KD
authors.lastname: Olsen
authors.forename: Colin
authors.initials: C
authors.lastname: Driscoll
authors.forename: Jean E
authors.initials: JE
authors.lastname: Lewis
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McDonald
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018277:Carcinoma, Mucoepidermoid / Q000150:complications / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology; D003390:Cranial Nerve Neoplasms / Q000150:complications* / Q000473:pathology; D005155:Facial Nerve Diseases / Q000150:complications* / Q000473:pathology; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009382:Neoplasms, Unknown Primary / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies