Neglected left intraparotid facial nerve schwannoma causing complete facial nerve palsy: A case report

Khim Soon Vong,Irfan Mohamad,J Rohana

doi:10.3329/bjms.v17i4.38338

Khim Soon Vong, Irfan Mohamad + Show 1 more

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https://doi.org/10.3329/bjms.v17i4.38338

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Abstract

Extracranial schwannomas in the head and neck region are relatively rare neoplasms. The tumours are slow growing and often unnoticeable. The nerve of origin is unable to be determined until the time of surgery. Proper preoperative assessment of the disease can be done by imaging studies such as magnetic resonance imaging. The treatment for these tumours is surgical resection with preservation of the neural pathway. We report a case of left intraparotid facial nerve schwannoma in a middle-aged lady causing complete facial nerve paralysis. The clinical features, diagnostic possibilities and management are discussedBangladesh Journal of Medical Science Vol.17(4) 2018 p.680-682

Highlights

Schwannomas, known as neurilemmomas or neurinomas are benign, slow-growing, encapsulated nerve sheath neoplasm that arises from Schwann cells which may originate from any peripheral, cranial or autonomic nerve of the body.[1]
We report a case of neglected left intraparotid facial nerve schwannoma causing complete facial nerve paralysis which successfully excised but poor postoperative facial nerve function
The left facial nerve function was identified as House-Brackmann VI (Figure 1)

Summary

Introduction

Schwannomas, known as neurilemmomas or neurinomas are benign, slow-growing, encapsulated nerve sheath neoplasm that arises from Schwann cells which may originate from any peripheral, cranial or autonomic nerve of the body.[1]. We report a case of neglected left intraparotid facial nerve schwannoma causing complete facial nerve paralysis which successfully excised but poor postoperative facial nerve function. Contrast-enhanced magnetic resonance imaging (MRI) scan showed a well-defined lobulated lesion in the left stylomastoid foramen with extension into the left parotid gland (intraparotid involvement and left carotid space, measuring 2.8 cm (AP) x 4.7 cm (W) x 3.2 cm (CC). It has cystic degeneration within the parotid gland, which displaced the gland laterally, and common carotid artery and internal jugular vein anteromedially (Figure 2). The patient was planned for facial reanimation later patient defaulted follow up

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