Surgical treatment of patients with facial neuromas--a report of 26 consecutive operations.
OBJECTIVE
To analyze surgical treatment and outcome in patients with facial neuromas at a tertiary referral hospital.


METHODS
A chart review of 26 patients treated between 1971 and 2006, with questionnaire follow-up ranging from 2 to 19 years. All patients except one were operated with radical tumor removal approaches.


RESULTS
Approximately 54% of the patients presented with symptoms related to the VIIth cranial nerve (facial palsy and facial spasm), 58% with symptoms related to the VIIIth cranial nerve (hearing deficit, tinnitus, and vertigo), and 8% related to the Vth cranial nerve (facial pain and facial sensory deficit). Approximately 39% presented with no facial symptoms. Twenty-one patients received a facial nerve graft from the greater auricular nerve or the sural nerve; 1 patient had an accessory-facial anastomosis. One patient had a subtotal tumor removal preserving the facial nerve. Three patients were not grafted. Most tumors (88%) affect the geniculate ganglion. Approximately 82% of the grafted patients regained a House-Brackmann facial nerve function (HB) grade III; 14% regained HB grades IV to V. No serious morbidity or mortality was reported. No recurrences have been reported where a total tumor removal was performed.


CONCLUSIONS
Surgical removal of facial neuroma is a safe procedure with a low complication rate and a low recurrence rate. First symptoms are diverse and are predominantly derived from the facial and vestibulocochlear nerve. Facial nerve grafting is reliable, giving the patient an acceptable facial nerve function (HB III).
Günther
Mattias
M
Department of Neurosurgery, Uppsala University Hospital, Uppsala, Sweden. mattias_gunther@hotmail.com
Danckwardt-Lillieström
Niklas
N
Gudjonsson
Olafur
O
Nyberg
Gunnar
G
Kinnefors
Anders
A
Rask-Andersen
Helge
H
Ekvall
Lars
L
D000328:Adult; D017668:Age of Onset; D000368:Aged; D003390:Cranial Nerve Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D003391:Cranial Nerves / Q000637:transplantation; D005154:Facial Nerve / Q000473:pathology / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D055815:Young Adult