Hemangiomas of the geniculate ganglion.
OBJECTIVE
To describe the presentation, evaluation, and management of patients with geniculate ganglion hemangioma.


METHODS
Retrospective case review.


METHODS
Tertiary-care academic medical center.


METHODS
Six patients with hemangiomas of the geniculate ganglion, evaluated and managed at a single institution.


METHODS
All patients underwent imaging and follow-up, with five of the patients undergoing operative intervention.


METHODS
Tumor size and extent, facial nerve and hearing function, histopathologic findings, and complications are discussed as a function of observation versus microsurgical excision.


RESULTS
Six patients with ossifying hemangiomas of the geniculate ganglion were evaluated at a single institution over a 10-year period. These patients underwent operative intervention when their facial nerve function began to decline. Hearing was preserved in five of the six cases. Resection and grafting of the facial nerve was required in five of six cases. Two of the six cases were found to have histologic evidence of facial nerve infiltration on pathologic examination.


CONCLUSIONS
The majority of these tumors infiltrated the facial nerve and could not be completely removed without excision of the nerve itself. Based on this experience, it would seem reasonable to defer surgical excision until facial nerve function has declined to grade 3 or worse. Whether earlier subtotal excision would result in better outcomes or not remains unanswered. This study presents several complicated scenarios that illustrate the difficulty of clinical decision-making in this disease. Associated clinical dilemmas and controversies are discussed.
Isaacson
Brandon
B
Department of Otolaryngology-Head and Neck Surgery and Pathology, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0312, USA.
Telian
Steven A
SA
McKeever
Paul E
PE
Arts
H Alexander
HA
D000328:Adult; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D005154:Facial Nerve / Q000473:pathology / Q000601:surgery / Q000637:transplantation; D005260:Female; D005830:Geniculate Ganglion / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006309:Hearing; D006391:Hemangioma / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011184:Postoperative Period; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed