title: Management outcomes of facial nerve tumors: comparative outcomes with observation, CyberKnife, and surgical management.
abstract: OBJECTIVE
  Primary facial nerve tumors (FNTs) present in varying ways. In this study, the authors present their institutional experience with the management of facial nerve tumors, including their recommendations for available therapies such as observation, microsurgical decompression or removal, and stereotactic radiation. They emphasize the auditory and facial nerve function outcomes.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Retrospective review of all cases of FNT seen at the authors' tertiary care academic medical center over a 10-year period (2002-2011). The clinical presentation, treatment modality, and outcome parameters of cochlear and facial nerve function were assessed.
  
  
  RESULTS
  Twelve patients were identified. House-Brackmann grades on presentation were 4 grade I, 2 grade II, 2 grade III, 1 grade IV, and 3 grade V, with 2 grade V patients declining to grade VI shortly after presentation. Seven patients presented with serviceable hearing and 4 with nonserviceable hearing. Treatment options/arms included observation with serial clinicoradiological review (2 cases), stereotactic radiation with the CyberKnife (3 cases), wide fallopian canal decompression (3 cases), microsurgical excision and repair (3 cases), and biopsy followed by observation (1 case). At the end of the review period, facial nerve function was stable in 8 patients, improved in 3, and declined in 1, and none had documented worsening of hearing based on American Academy of Otolaryngology--Head and Neck Surgery Foundation classification.
  
  
  CONCLUSIONS
  Management of FNT is largely based on the clinicoradiological picture. Each treatment arm is different, but overall auditory and facial function can be maintained.
authors.affiliation: Department of Otolaryngology, University of Miami, Miami, Florida 33136, USA.
authors.forename: Guyan A
authors.initials: GA
authors.lastname: Channer
authors.forename: Björn
authors.initials: B
authors.lastname: Herman
authors.forename: Fred F
authors.initials: FF
authors.lastname: Telischi
authors.forename: Daniel
authors.initials: D
authors.lastname: Zeitler
authors.forename: Simon I
authors.initials: SI
authors.lastname: Angeli
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001706:Biopsy; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation; D005154:Facial Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005155:Facial Nerve Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000295:instrumentation; D008875:Middle Aged; D060787:Neoplasm Grading; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D016634:Radiosurgery / Q000295:instrumentation*; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D014057:Tomography, X-Ray Computed