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A patient with a progressive peripheral facial paralyses should be considered to have a tumor involved the facial nerve until proved otherwise. Haemangiomas of the temporal bone are uncommon and the present study discusses pathology, clinical presentation and therapeutic management of a tumor located at the geniculate ganglion. Complete surgical removal by the middle fossa approach is the treatment of choice with adequate margins and preservation of adjacent structures when it is oncologically possible. The surgeon must be familiar with all aspects of facial nerve repair.

Authors present one case of hemangiopericytoma of the infra-temporal fossa and the lateral wall of the nasopharynx. They describe the characteristics of this rare, recurrent and sometime malignant vascular tumor. The selected therapy is an aggressive and wide exeresis. The antero-inferior approach via the cervico-trans-oral route would seem to be of particular interest, offering good exposure of the anatomical features of the region avoiding the parotid bed ans dissection of the facial nerve.