title: Primary tumors of the facial nerve misdiagnosed: a case series and review of the literature.
abstract: CONCLUSIONS
  Unusual primary tumors of the facial nerve should be considered in patients with progressive facial paralysis, especially if this is accompanied by hearing loss or vertigo. Misdiagnosis could increase the difficulties of operation, diminish the chance of facial nerve reconstruction, and increase the likelihood of poor reconstructive outcomes.
  
  
  OBJECTIVE
  This paper was to determine the characteristics of facial nerve primary tumors misdiagnosed as tumor-free conditions many years prior, and to describe appropriate treatments.
  
  
  METHODS
  The cases of 11 Chinese patients with misdiagnosed primary tumors of the facial nerve were reviewed; every one had been misdiagnosed for more than 8 years. All patients presented with progressive or complete facial paralysis and hearing loss, with or without vertigo. The pre- and post-operative images (including CT scans of the temporal bone) and MRI data were reviewed.
  
  
  RESULTS
  All tumors were completely resected using the translabyrinthine or transmastoid approach and were confirmed to be primary tumors of the facial nerve. Facial-hypoglossal nerve anastomosis failed because fibrosis developed at the end of the facial nerve in one patient whom this study sought to manage in two stages. One patient accepted facial-hypoglossal nerve anastomosis of two-stage and patient status improved to House-Brackmann (H-B) grade V from H-B grade VI. The other nine patients chose not to undergo reconstruction.
authors.affiliation: a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University , Beijing , PR China.
authors.forename: Haijin
authors.initials: H
authors.lastname: Yi
authors.affiliation: a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University , Beijing , PR China.
authors.forename: Bin
authors.initials: B
authors.lastname: Hu
authors.affiliation: a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University , Beijing , PR China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Yin
authors.affiliation: a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University , Beijing , PR China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University , Beijing , PR China.
authors.forename: Jinkun
authors.initials: J
authors.lastname: Xu
authors.affiliation: a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University , Beijing , PR China.
authors.forename: Jingying
authors.initials: J
authors.lastname: Ye
authors.affiliation: b Department of Otolaryngology, Head & Neck Surgery , Institute of Otolaryngology of PLA, Chinese PLA General Hospital , Beijing , PR China.
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Yang
mesh_terms: D000368:Aged; D003951:Diagnostic Errors; D005153:Facial Neoplasms / Q000000981:diagnostic imaging*; D005155:Facial Nerve Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging*
keywords: Tumors; facial nerve; misdiagnosed; surgery