Unfortunately, some of these tumors are malignant and require excision of the nerve with the tumor. This was the case with the following patient. Removal of the tumor not only required removal of the 7th nerve but also left a large defect.
We closed this defect with a pectoralis major myocutaneous flap:
The patient had a good recovery and will be ready for adjuvant radiation therapy much faster as a result of the flap coverage