Abstract
A 42-year-old woman presented with slowly progressive left-sided facial paralysis in association with some hemifacial spasm that had developed over a period of 8 years. A whitish large mass at posterio-inferior aspect of the tympanic cavity was found through the left tympanic membrane and audiometric testing revealed mild conductive hearing losses for lower-frequencies in the left ear. Magnetic resonance imaging (MRI) with gadolinium enhancement showed a large neurogenic lesion involving throughout the mastoid segment of the facial nerve with the peripheral extension beyond the stylomastoid foramen. These findings were confirmed at surgery and intratemporal tumor was totally removed. Unfortunately nerve grafting could not be attempted since the tumor was too large and extended to the extratemporal region beyond the stylomastoid foramen. We should perform MRI on patients with unilateral facial paralysis if possible, since diagnosis and surgery during the early state provide a better prognosis for facial nerve function.
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