Facial Nerve Neuroma in the Mastoid Segment of the Temporal Bone: A Case Report

Facial nerve neuroma is a rare disease that comprises less than 1% of all intrapetrous mass lesions. Diagnosis of the lesions of the tumor is difficult, as these tumors have relationships with other structures of the lateral skull base, such as nerves. In addition, surgical treatment is difficult because the risk of injury after the intervention is high. In this case report, we describe the clinical findings, diagnosis, and treatment of a 55-year-old man with facial nerve neuroma in the mastoid portion, a rare type of neuroma who underwent surgical operation at Khalili Hospital, Shiraz, Iran. In this report, we describe a rare facial nerve neuroma in the mastoid portion in a 55-year-old man with a history of hypertension (HTN) and diabetes mellitus (DM). The patient also had otalgia related to the periauricular area, otorrhea, and tympanic membrane retraction on the left side. In addition, the patient had facial palsy (Brackmann grade V) and often suffered from headaches. Magnetic resonance imaging (MRI) with contrast, biopsy from the external ear canal region, and tympanometry were carried out. Then, the patient underwent surgical treatment, and the mass was successfully totally removed. The result of the patient’s pathology test was margin free. At a recent follow-up, the patient was still symptom-free (otalgia and headache). In surgery for facial nerve neuroma in the mastoid segment, it is better not to rely on imaging alone; all facial nerves from the geniculate ganglion to the styloid foramen become exposed for tumor removal