Massive Facial Neurofibromas: Review of the Literature, New Classification System and Case Presentations

Massive facial neurofibromas are rare, occurring in 1 in 300,000 individuals. In the presented article, we review the literature and our recent experience with MFNs. We provide an overview of management strategies and develop a classification system and treatment algorithm based on modern treatment options. In this comprehensive review, Ovid Medline and the Cochrane library were mined for the relevant literature. Articles were extracted from the bibliographies of selected papers. The literature search returned 52 articles including literature reviews, case series and case studies. We developed a three tiered classification system, based on the anatomical structures affected by the MFN. Our treatment algorithm provides concise guidelines for preoperative planning.