[Intrapetrous neurinoma of the facial nerve. Removal by the oto-neurologic route].

A case of a 33 year-old woman presenting an intrapetrous facial nerve neurinoma is reported. The neurological finding was a quickly progressive facial nerve palsy without hearing loss which the initial diagnosis was a Bell's palsy. The radiological findings showing an petrous bone erosion located at the third portion of the facial nerve gave the diagnosis. It was confirmed by CT scan and arteriography that allows a pre-operative embolisation. A one stage operation performed by a triple retromastoid, transpetrous and retroparotid approach, allowed a complete removal. The post-operative course was uneventful and a reconstructive facial surgery was performed to restore a facial symmetry six months later. The authors review the literature about this tumor which remains rare and point out two facts: --A non regressive or recurrent or atypical facial nerve palsy had to be checked up by neuroradiology and even by surgical exploration. --The triple retromastoid, transpetrous and retroparotid approach is very interesting, allowing a one stage complete removal of the tumor and a check up of the facial nerve repair possibilities.