Perineural spread of facial squamous cell carcinoma (SCC) is a well-recognized cause of trigeminal and of facial nerve palsies.1 Vestibulocochlear nerve involvement by perineural spread has not been convincingly demonstrated. Here we report a patient with perineural spread of facial SCC not only to the trigeminal and facial nerves but also to the ipsilateral vestibulocochlear nerve. The anatomic and pathophysiologic basis of this spread is discussed.
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