Management of Intratemporal Facial Nerve Schwannoma

Abstract

The aim of this study was to report a series of 18 facial nerve schwannomas, including 2 infantile cases. Retrospective case review. Tertiary referral center. Eighteen patients with facial nerve schwannoma, operated on between 1980 and 2000. Surgical treatments were performed in all cases. The presenting symptoms and facial nerve function were graded using the House-Brackmann scale and eye closure. Facial nerve paralysis was the most common symptom, presenting in 94% of cases, followed by hearing loss and mass lesion. In one case, the tumor was shaved, leaving the facial nerve intact. In the other cases, the facial nerve reconstruction with hypoglossal-facial anastomosis or interposition graft was performed. The postoperative facial function was House-Brackmann grade IV in most cases (88.2%). In terms of the functional recovery classified by complete or incomplete eye closure, the moderate preoperative facial nerve palsy group showed a better functional outcome than severe group. In cases with good facial nerve function, it would be better to consider an alternative method for preserving the facial nerve. Furthermore, when facial nerve paralysis has developed to more than House-Brackmann grade III, an immediate operation is recommended to obtain a good postoperative facial functional recovery.