Primary tumors of the facial (extracranial) nerve

Nearly 25% of all primary neurogenous tumors arise from peripheral nerves in the head and neck. The extracranial parts of the facial nerve, however, rank low as potential sites. Their tumors nonetheless pose diagnostic and management problems. In the intraparotid location the neurogenous tumors most often present as mass lesions, accompanied, in one third of patients, by various degrees of facial weakness. With the exception of a peculiar predilection of childhood plexiform neurofibromas to afflict the facial nerve, the majority of the tumors are neurilemomas. Recurrences are unusual after surgical removal of either neurilemomas or neurofibromas. The rare facial nerve sarcoma is a high-grade malignancy.