INTRACRANIAL FACIAL-NERVE NEURINOMA - SURGICAL STRATEGY OF TUMOR REMOVAL AND FUNCTIONAL RECONSTRUCTION

BACKGROUND Three cases with intracranial facial neurinoma underwent tu mor removal and facial nerve reconstruction with or without tympanopla sty. Surgical strategy for each case was tailored to: (1) the site of main tumor mass, (2) its extension along the facial nerve, and (3) inv olvement of the auditory organs. METHODS Surgeries adopted in the thre e cases were: transpetrosal approach with intracranial-intratemporal f acial nerve anastomosis, middle fossa and transmastoid approach with i ntratemporal facial nerve anstomosis and tympanoplasty, and middle fos sa and transmastoid approach with intracranial-intratemporal facial ne rve anastomosis and tympanoplasty. The greater auricular nerve was use d as the nerve graft for all three cases. RESULTS In the follow-up per iod of 8-13 months there was no tumor recurrence; facial function was scored 20/90 in modified May's scoring system in each case, but two ar e still in the process of functional recovery. One of the two cases wh o underwent tympanoplasty showed complete recovery of hearing within 1 month, and the other showed worsened hearing, which was not serviceab le at 3 months postoperatively. CONCLUSION Systematic surgical approac h for tumor removal, facial nerve reconstruction, considered in cases with intracranial facial neurinoma due to its varied clinical features . (C) 1998 by Elsevier Science Inc.