Ungar OJ, et al. - In primary and metastatic malignancies of the human temporal bone (TB), researchers characterized the histopathologic findings and clinical presentation of intra-temporal facial nerve invasion. In 16 patients, 18 TBs were identified. A retrospective analysis was performed on all medical records of patients diagnosed with malignant-origin peripheral facial nerve palsy (PFnP). The most common clinical presentation affecting nine patients was complete facial nerve paralysis (House-Brackmann [HB] grade VI). The meatal segment, followed by the labyrinthine, tympanic, and vertical segments was the most commonly involved cranial nerve (CN) VII segment. Findings suggested that PFnP may lead from local, regional, or distant malignancy and is linked to poor survival. The facial nerve can serve intracranially as a route of tumor progression. While tumors can violate every segment of CNV II, not all PFnP are associated with direct tumor invasion.