Facial reflex examination for assessment of trigeminal nerve involvement in pituitary fossa tumours.

Sixteen patients with pituitary fossa tumours with different intrasellar extension have been studied by facial reflex examination, a neurophysiological test for the trigemino-facial pathway. Impaired transmission along the reflex path was shown in patients with proved encroachments on the flexible walls of the cavernous sinuses, but with no tumour spread to the brain stem and facial nerve. The findings were consistent with a subclinical involvement of the first trigeminal division. Tumour removal resulted in recovery in nerve conduction. It is concluded that facial reflex examination is a valuable test for detecting cavernous sinus involvement in pituitary fossa tumours.