Tumors

Facial nerve paralysis can be caused by tumors. Acoustic neuroma, cholesteatoma, schwannoma, and invasive carcinomas are among the more common tumors.

Symptoms may vary from an acute paralysis that shows no improvement over several months to a slowly progressive paralysis that’s often accompanied with synkenisis (abnormal twitching or motion in the face).

Early diagnosis is critical and imaging studies, such as CT scans and MRIs, are usually needed to identify the extent of the tumor. Based on the imaging findings, the treatment plan may involve surgery, radiation, or both.

The removal of tumors itself may cause facial paralysis. However, inadvertent injury to the facial nerve is uncommon in the hands of experienced skull-base surgeons, usually otolaryngologists and neurosurgeons.

When a tumor is very close to the facial nerve or even surrounding the facial nerve, temporary or permanent facial paralysis may occur after tumor removal. In some cases, especially if cancerous tumors are involved, the facial nerve may be altered to obtain clear removal of the tumor.