Traumatic facial nerve neuroma with facial palsy presenting in infancy

OBJECTIVE:: To describe the management of traumatic neuroma of the facial nerve in a child and literature review. PATIENT:: Sixteen-month-old male subject. INTERVENTION:: Radiological imaging and surgery. MAIN OUTCOME MEASURES:: Facial nerve function. RESULTS:: The patient presented at 16 months with a right facial palsy and was found to have a right facial nerve traumatic neuroma. A transmastoid, middle fossa resection of the right facial nerve lesion was undertaken with a successful facial nerve-to-hypoglossal nerve anastomosis. The facial palsy improved postoperatively. CONCLUSION:: A traumatic neuroma should be considered in an infant who presents with facial palsy, even in the absence of an obvious history of trauma. The treatment of such lesion is complex in any age group but especially in young children. Symptoms, age, lesion size, growth rate, and facial nerve function determine the appropriate management.