FACIAL-NERVE NEUROMAS PRESENTING AS ACOUSTIC TUMORS

Facial nerve tumors can present as masses in the internal auditory can al or cerebellopontine angle and may mimic an acoustic neuroma. These tumors can occur in any segment of the nerve from the brain stem to th e neuromuscular junction. Prior to the advent of computed tomography a nd magnetic resonance imaging with gadolinium, facial nerve tumors wer e often difficult to diagnose. Even with these modalities it may be di fficult to distinguish preoperatively between an acoustic neuroma and a facial schwannoma. Particular signs and symptoms associated with fac ial nerve tumors (in the absence of a motor deficit) include taste dis turbances, spasms, and a facial tic. These symptoms, combined with mod ern radiologic studies, should allow for more accurate diagnosis, pati ent counseling, and treatment. This report presents a series of 32 fac ial nerve tumors diagnosed and treated at The Otology Group from 1975 to 1992. Of these lesions, 12 (38%) were thought to be acoustic neurom as. Eighteen tumors were correctly identified preoperatively as facial nerve tumors. Two facial nerve tumors were found incidentally.