Peri-neural invasion right facial nerve

Inital diagnosis of right sided Bell’s Palsy with dense right sided facial nerve paresis. Partial recovery over 6 months.

Development of severe vertigo and profound hearing loss 1 year later

Negative PET scan

Translabyrinthine approach to IAC/CPA. Biopsy revealled high grade salivary duct carcinoma.

Temporal bone resection with transection of the facial nerve at brainstem with clear margins, neck dissection and post-operative radiotherapy.