gms | German Medical Science

The peripheral facial nerve paralysis is often caused by a idiopathic genesis. Other reasons could be a congenital, infective or tumoral variance of the facial nerve.

2010 an eigthteen years old patient came with tinnitus of the left ear in our clinic. Additionally he had a paralysis of the left-sided facial nerve. The posterior part of the tympanic membrane showed a protrusion. In the CT of the petrousus bone could be seen an opacity of the left tympanic cavity. Because of the also seen osseous arrosion the explorative tympanotomy followed. During the surgery we found a tumor around the osscile chain. The facial nerve was discovered completely.

As the tumor was elevated we saw a liquorrhoea so that the suspicion of an intracranial growth raised. The surgery was stopped a finally the ossicle chain was reconstructed with a titan implant. The histological analysis ensured a primitive neuroectodermal tumor. In the following staging no metastasis could be found. There was no opportunity for a neurosurgical intervention. After the radio-chemotherapy at a pediatric oncological center the young patient shows no residual tumor or metastasis while the paralysis of the facial nerve persists.

If a combination of a paralysis of the facial nerve and a pathological CT of the petrousus bone is be seen an explorative tympanotomy should follow. This is the only way to identify such rare tumors and induce the adequate therapy.