Facial Nerve Schwannoma Located in Middle Cranial Fossa

Facial nerve schwannomas are uncommon tumors. A 40-year-old female presented with left-side facial weakness. Computed tomography(CT) imaging showed a 3 x 2cm lesion on the posterior portion of the left middle cranial fossa. The mass abutted the anterior aspect of the left petrous bone with a wide erosive change involving the area of the left facial nerve ganglion (geniculate ganglion). A well-circumscribed extra-axial mass was seen on magnetic resonance imaging(MRI). The tumor was completely removed through subtemporal approach and the patient was discharged without additional neurological deficit. This rare case is discussed and a review of the relevant literature is presented.

Surgical Management of the Facial Nerve Schwannoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The facial nerve schwannoma, hard to diagnose due to its rareness and relatively slow growth rate, is best managed by surgical procedures. We have tried to find the most useful management strategy for the facial nerve schwannoma. MATERIALS AND METHODS: We reviewed 11 cases of facial nerve schwannoma which were surgically treated. We analyzed the treatment results according to the age of the patient, the size and site of the tumor and accompanying symptoms. RESULTS: The clinical manifestations were various and surgical approaches were determined according to the age, site and size of the tumor, preoperative facial nerve function and hearing. When the preoperative facial nerve functions were better than House-Brackmann grade III, the results of the surgical treatments were favorable, but when worse than House-Brackmann grade IV, the results were unfavorable. CONCLUSION: For the treatment of the facial nerve schwannoma, the site and size of the tumor, age of the patient, preoperative hearing level and facial nerve function are considered as the decisionmaking factors. We proposed the flow-sheet of the management of the facial nerve schwannoma. Patients with no or mild facial palsy preoperatively can be managed by enucleation only. Patients with more than moderate degree facial palsy or large tumor can be managed by total resection with reconstruction of the facial nerve, which results in somewhat unfavorable results in respect to the facial nerve function.

A Case of Facial Nerve Schwannoma Extending into the Middle Cranial Fossa / 대한이비인후과학회지

Schwannomas of the facial nerve are uncommon tumors, accounting for about 0.8% of all intrapetrous mass lesion.1-3) Very rarely do these lesions acts as expansile tumors of the petrous bone that extend to involve the intracranial cavity.1-10) Recently we experienced 1 case of facial nerve schwannoma unusually extending into middle cranial fossa which was removed by transcochlear and middle fossa approach. So we report the case with review of literature.

The Management of Facial Nerve Schwannoma / 대한이비인후과학회지

Facial nerve schwannomas are uncommon tumors that involve the facial nerve. They are frequently misdiagnosed due to subtle and variable clinical presentations. The aim of management of facial nerve schwannoma is the complete removal of tumor, combined with preservation or restoration of facial nerve continuity. The site, size of the tumor, age, preoperative hearing level and facial nerve function are consider as decision making factors. But, it is management dilemma to decompress or resect the tumor. The purpose of this paper is to discuss to surgical management of complete removal of tumor and successful facial nerve reconstruction. Recently, we experienced three patients with facial nerve schwannoma with relatively good surgical result.