Facial neuromas in children: Delayed or immediate surgery?

Objective: The objective of this study was to investigate the clinical char acteristics and outcome of facial nerve neuromas in children. To date, no s pecific study has focused on children, and the management of these tumors i s not codified. Design and Settings: A review of case series treated in a tertiary care cen ter of pediatric otolaryngology. Subjects: The treatment and outcomes for 7 children (4 infants and 3 adoles cents) were analyzed. Results: Six patients underwent complete removal of tumor and immediate res toration of the nerve continuity. The grade of facial palsy improved in 4 o f the 6 children, but did not get better than grade 3 (House classification ). The remaining patient was managed conservatively and remained stable cli nically and radiologically after 9 years follow-up. Conclusions: These findings support the reasonable strategy of combining co nservative assessment of these slow-growing tumors with regular clinical an d radiologic evaluations and radical surgery using various procedures. The choice depends on the age of the child, the extent and growth rare of the t umor, the grade of facial palsy, and the hearing function.