Intratemporal Traumatic Neuromas of the Facial Nerve: Evidence for Multiple Etiologies

Objective To describe 2 patients with traumatic neuromas of the intratemporal facial nerve in the absence of trauma. Study Design Retrospective case review. Setting Tertiary care referral center. Patients Patients included underwent resection of an intratemporal facial nerve mass. Upon pathologic evaluation, the patients were found to have traumatic neuromas of the facial nerve. Intervention(s) Patients underwent resection of an intratemporal facial traumatic neuroma. Histopathologic evaluation was performed including an immunohistochemistry evaluation. Results Two patients were identified with intratemporal facial nerve traumatic neuromas. The patients had no significant history of trauma or chronic inflammatory process. Pathologic evaluations, including immunohistochemistry, of the excised masses were consistent with traumatic neuromas. All tumors were noted to have a disorganized collection of axons and were not consistent with the expected diagnosis of schwannoma. Tumors involved the tympanic and vertical segments of the facial nerve. A cavernous angioma was found within one mass and is thought to be the etiology of neuroma formation. Conclusion Traumatic neuromas are possible in the intratemporal facial nerve in the absence of trauma. A cavernous angioma of the facial nerve is a newly described possible cause of traumatic neuroma formation.