Facial nerve paralysis secondary to occult malignant neoplasms

Derek O. Boahene, Kerry D. Olsen, Colin Driscoll, Jean E. Lewis, Thomas J. McDonald

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


OBJECTIVE: This study reviewed patients with Unilateral facial paralysis and normal clinical and imaging findings who underwent diagnostic facial nerve exploration. STUDY DESIGN AND SETTING: Fifteen patients with facial paralysis and normal findings were seen in the Mayo Clinic Department of Otorhinolaryngology. RESULTS: Eleven patients were misdiagnosed as having Bell palsy or idiopathic paralysis. Progressive facial paralysis with sequential involvement of adjacent facial nerve branches occurred in all 15 patients. Seven patients had a history of regional skin squamous cell carcinoma, 13 patients had surgical exploration to rule out a neoplastic process, and 2 patients had negative exploration. At last follow-up, 5 patients were alive. CONCLUSIONS: Patients with facial paralysis and normal clinical and imaging findings should be considered for facial nerve exploration when the patient has a history of pain or regional skin cancer, involvement of other cranial nerves, and prolonged facial paralysis. SIGNIFICANCE: Occult malignancy of the facial nerve may cause unilateral facial paralysis in patients with normal clinical and imaging findings.

Original languageEnglish (US)
Pages (from-to)459-465
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Issue number4
StatePublished - Apr 2004
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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