Facial nerve neuromas presenting as acoustic tumors

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