Primary tumors of the facial nerve: diagnosis and management.

Benign primary tumors of the facial nerve are frequently misdiagnosed because of variable and subtle clinical manifestations. Three such cases of facial nerve neuroma seen in the past 3 years will be presented. Difficulties in patient assessment including the lack of specificity for topographic testing, as well as the capricious behavior of the facial nerve in these patients will be discussed. The efficacy of diagnostic techniques presently available and in use including computerized tomography and electrodiagnostic studies will be discussed. Diagnosis of these tumors might generally be thought to be straightforward and easier with the advent of new diagnostic techniques, but this has, in fact, not been the case. Techniques for removal and repair will be presented. The combined approach utilizing the mastoid and middle fossa will be presented.