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Updated: Jun 24, 2026
04:34
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
Parotid tumor presenting with hemifacial spasm.
Raed Behbehani1, Abdulmohsen E Hussain, Ali N Hussain
1Oculoplasic and Orbital Surgery Service, Ibn Sina Hospital, Kuwait City, Kuwait. r_behbehani@hotmail.com
Ophthalmic Plastic and Reconstructive Surgery
|March 21, 2009
Summary
Occult parotid tumors can mimic hemifacial spasm. Surgical removal of pleomorphic adenoma did not resolve spasms, but botulinum toxin-A injections provided symptom relief.
Area of Science:
- Neurology
- Otolaryngology
- Oncology
Background:
- Hemifacial spasm is characterized by involuntary contractions of facial muscles.
- Parotid gland tumors, such as pleomorphic adenoma, can cause localized swelling.
- Differential diagnosis for facial spasms is crucial for effective treatment.
Observation:
- A 47-year-old male presented with right parotid swelling and a history of hemifacial spasm.
- MRI revealed a right parotid gland mass, diagnosed as pleomorphic adenoma via biopsy and confirmed post-surgery.
- Post-parotidectomy, hemifacial spasms persisted, indicating the tumor was not the primary cause.
Findings:
- Pleomorphic adenoma of the parotid gland was surgically removed.
- Botulinum toxin-A injections were administered 8 months postoperatively, significantly improving hemifacial spasm symptoms.
- The patient's persistent spasms post-surgery suggest an independent neurological origin.
Implications:
- Clinicians should consider occult parotid tumors in patients presenting with hemifacial spasm.
- This case highlights the importance of a thorough diagnostic workup for both neoplastic and neurological conditions.
- Botulinum toxin-A is an effective treatment for refractory hemifacial spasms, even when a parotid mass is initially suspected as the cause.
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