Facial Schwannoma Research Articles

A Synchronous Facial Nerve Schwannoma and Neurofibroma: Case Report and Review of the Literature

The LaryngoscopeVolume 121, Issue S4 p. S119-S119 Triological Society 2011 Combined Sections Meeting Posters A Synchronous Facial Nerve Schwannoma and Neurofibroma: Case Report and Review of the Literature BC Gross, BC Gross Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this authorML Carlson, ML Carlson Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this authorB Scheithauer, B Scheithauer Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MNSearch for more papers by this authorCLW Driscoll, CLW Driscoll Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this authorEJ Moore, EJ Moore Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this author BC Gross, BC Gross Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this authorML Carlson, ML Carlson Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this authorB Scheithauer, B Scheithauer Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MNSearch for more papers by this authorCLW Driscoll, CLW Driscoll Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this authorEJ Moore, EJ Moore Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester, MNSearch for more papers by this author First published: 28 June 2011 https://doi.org/10.1002/lary.21996AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume121, IssueS4Supplement: Triological Society 2011 Combined Sections Meeting Posters2011Pages S119-S119 RelatedInformation

被膜内摘出術を行った耳下腺内顔面神経鞘腫例

Intraparotid facial nerve schwannoma, an uncommon tumor documented sporadically in medical literature, must be differentiated from pleomorphic adenoma. Function-preserving surgical resection is also important. We report a case of intraparotid facial nerve schwannoma in a 42 year-old woman seen for a right parotid gland tumor 28 mm in diameter. Computed tomography (CT) and Magnetic resonance imaging (MRI) showed a noninvasive round mass between the tip of the mastoid process and the mandibular condyloid process. Fine-needle aspiration cytology confirmed a benign mass consisting of histiocytes or interstitial cells, although preoperative tests could not differentiate schwannoma from pleomorphic adenoma. Surgical exploration found a yellow encapsulated mass arising in the main facial nerve trunk and the nerve funiculus extending into the capsule. A surgeon diagnosed a facial neurogenic tumor, which was resected intracapsularly leaving no tumor tissue in surgical microscopy. Postoperative facial palsy eventually disappeared, completely restoring facial nerve function. No recurrence has been seen in the 7 years and 8 months since surgery, indicating that intracapsular resection may be an intraparotid schwannoma treatment providing a favorable prognosis.

A rare case of greater petrosal nerve schwannoma

Background:Facial nerve schwannomas include only 0.8% of all intrapetrous mass lesions, and schwannomas originating exclusively from the greater petrosal nerve (GPN) are extremely rare. To date, only 13 reports have been described. In this case, the tumor was thought to originate from the GPN on the basis of clinical, radiological, and operative findings.Case Description:A 23-year-old girl presented an acute left facial palsy, a disturbance in tear secretion of the ipsilateral eye, and a left-sided conductive hypoacusia. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an extradural mass in the left middle fossa. A subtemporal approach was performed and the lesion, originating from the proximal portion of the GPN, was excised. The post-operative course was satisfactory, except for a xerophtalmia, which was treated with artificial teardrops.Conclusion:GPN schwannomas can originate anywhere alongside the course of the nerve, from its proximal segment near the facial hiatus to its distal segment near the foramen lacerum. For these reasons, it requires differential diagnosis with trigeminal nerve schwannomas or with injuries arising from the geniculate ganglion, because it can be easily confused with those lesions. However, in less severe cases, an early diagnosis can be able to preserve the function of the facial nerve by reducing iatrogenic injuries caused by surgical maneuvers.

Intraparotid facial nerve schwannoma: management decision based on facial nerve function. The Mayo Clinic Experience

The LaryngoscopeVolume 121, Issue S5 p. S279-S279 Triological Society's 2011 Annual Meeting Intraparotid facial nerve schwannoma: management decision based on facial nerve function. The Mayo Clinic Experience Brian C Gross M.D., Brian C Gross M.D. Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester MNSearch for more papers by this authorKerry D. Olsen M.D., Kerry D. Olsen M.D. Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester MNSearch for more papers by this authorEric J. Moore M.D., Eric J. Moore M.D. Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester MNSearch for more papers by this author Brian C Gross M.D., Brian C Gross M.D. Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester MNSearch for more papers by this authorKerry D. Olsen M.D., Kerry D. Olsen M.D. Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester MNSearch for more papers by this authorEric J. Moore M.D., Eric J. Moore M.D. Department of Otorhinolaryngology - Head and Neck Surgery Mayo Clinic Rochester MNSearch for more papers by this author First published: 15 August 2011 https://doi.org/10.1002/lary.22235Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume121, IssueS5Supplement: Poster Presentations from the Triological Society's 2011 Annual Meeting2011Pages S279-S279 RelatedInformation

Dos casos de schwannoma intraparotídeo del nervio facial

Intraparotid facial nerve schwannomas are rare, their preoperative diagnosis is difficult, and there are controversies about how to proceed when they are suspected intraoperatively. We present two cases of intraparotid facial nerve schwannoma that were diagnosed during parotid surgery, and describe the procedure and follow-up performed.

Facial Schwannoma Clinical Presentation and Surgical Managment

The LaryngoscopeVolume 120, Issue S3 p. S80-S80 Poster Presentations from the 2010 Triological Society Combined Section Meetings Facial Schwannoma Clinical Presentation and Surgical Managment Matthew L Kircher MD, Matthew L Kircher MD Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center - Maywood, ILSearch for more papers by this authorTimothy J Kovanda BS, Timothy J Kovanda BS Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center - Maywood, ILSearch for more papers by this authorJohn P Leonetti MD, John P Leonetti MD Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center - Maywood, ILSearch for more papers by this author Matthew L Kircher MD, Matthew L Kircher MD Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center - Maywood, ILSearch for more papers by this authorTimothy J Kovanda BS, Timothy J Kovanda BS Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center - Maywood, ILSearch for more papers by this authorJohn P Leonetti MD, John P Leonetti MD Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center - Maywood, ILSearch for more papers by this author First published: 14 December 2010 https://doi.org/10.1002/lary.21269AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume120, IssueS3Supplement: Poster Presentations from the Triological Society's 2010 Annual MeetingOctober 2010Pages S80-S80 RelatedInformation

Management of Facial Nerve Schwannoma in the Accessory Parotid Region

Management of Facial Nerve Schwannoma in the Accessory Parotid Region

Unilateral Rhinorrhea After Translabyrinthine Surgery Due to Parasympathetic Hypersensitive Syndrome

Unilateral rhinorrhea after translabyrinthine surgery for vestibular or facial schwannoma usually suggests cerebrospinal fluid (CSF) leakage and requires specific measures, including revision surgery. To draw attention to the possibility of postoperative unilateral rhinorrhea with concomitant hyperlacrimation and hypersialorrhea without a CSF origin and reflecting more a neuroplastic phenomenon. Retrospective study in a tertiary care center university clinic. For 1 case of intratemporal facial schwannoma and 2 cases of vestibular schwannoma, surgery was by a translabyrinthine approach with sacrifice of the facial nerve and hypoglossofacial anastomosis in the first case. Postoperative unilateral hydrorhinorrhea associated with various degrees of lacrimation and/or salivary hypersecretion occurred mainly during exercise or under stressful situations. With unilateral rhinorrhea after translabyrinthine surgery for vestibular or facial schwannoma, concomitant symptoms such as lacrimation or hypersialorrhea may not be explained by CSF leakage through the eustachian tube. Misinterpretation may lead to detrimental revision surgery. The pathophysiogenetic mechanism suggests a neuroplastic phenomenon involving a denervation hypersensitivity reaction of the autonomous system. A simple diagnostic test with a nasal anticholinergic agent may be beneficial.

Nonvestibular Schwannomas of the Head and Neck

Alper Ceylan MD, Assoc. Prof. Gazi University Medical Faculty Otorhinolaryngology Department, Ankara, Turkey Email: aceylan@gazi.edu.tr Phone: +90 312 202 64 25 Website: http://websitem.gazi.edu.tr/aceylan Objective: To assess the clinical presentation, location, nerve of origin, diagnosis and treatment of the nonvestibular head and neck schwannomas. Materials and methods: The clinical records of 15 patients with nonvestibular head and neck schwannomas treated at a single institution between 1982 and 2008 were reviewed retrospectively. Results: Eleven (73%) of 15 patients presented with symptoms secondary to mass effect. Facial nerve was the most common localization of schwannoma origin occurring in 6 patients (40%). All schwannomas were resected totally except the one in the pterygopalatin fossa. Three cases of facial schwannoma were found incidentally during chronic otitis media surgery. Conclusion: Facial nerve is one of the most commonly involved localizations for nonvestibular head neck schwannomas. This study indicated that extraordinary sites such as lingual, posterior pharyngeal wall and the suboccipital region may also be the origin of schwannoma. Schwannomas may also be encountered incidentally during chronic otitis media surgery. Complete tumor removal is often achieved, but subtotal resection may be indicated for patients with special indications. Nonvestibular Schwannomas of the Head and Neck Alper Ceylan MD, Fatih Celenk MD, Metin Yilmaz MD, Ozan Gokdogan MD, Erdogan Inal MD Gazi University Medical Faculty Otorhinolaryngology Department, Ankara, Turkey

Trends in the Management of Facial Schwannomas

Trends in the Management of Facial Schwannomas

Management of facial nerve schwannoma: A single institution experience

Conclusion: Difficulties in diagnosis, conservative initial steps in the management algorithm and intraoperative risks for facial nerve (FN) injury are divisive features for this tumour entity. Objective: The aim of the present study was to investigate the management and outcome of FN schwannomas (FNSs) at a tertiary referral centre and academic institution in a 30-year material. Methods: Data on age, sex, symptoms, tumour location, histopathological characteristics, imaging, management and outcome were retrospectively recorded. Results: Ten cases (six males, 60%), with a median age of 34.5 years (range 19–75 years) were identified. Five of the patients had intact FN function at the time of diagnosis. Five of the tumours were intraparotid and five were located in the temporal bone. Preoperative fine needle aspirations were non-diagnostic in all of the four patients presenting with a parotid mass. Nine patients were managed surgically. One patient is currently under conservative follow-up for a parotid schwannoma (diagnosed with magnetic resonance imaging) with intact FN function. No malignant schwannomas were encountered. The clinical outcome and histology will be discussed.

Parotidotomy approach for a midcheek mass: A new surgical strategy

To report the feasibility and the results of a new surgical strategy for midcheek masses we called the parotidotomy approach. Retrospective consecutive case series. Characteristics, surgical outcome, and cosmetic result of cases managed using the parotidotomy approach were collected by retrospectively reviewing medical records. The standard superficial parotidectomy approach was modified to dissect facial nerve branches selectively to obtain a symmetric facial contour. The parotid gland was fully bisected along the course of the zygomatic and buccal branches of the facial nerve to provide access to the midcheek mass. The bisected parotid gland was repositioned after mass excision. Seven patients (3 males and 4 females) were included in this study. The parotidotomy approach was accomplished in two cases with a malignant tumor (one acinic cell carcinoma, one low-grade mucoepidermoid carcinoma), four with a benign tumor (two pleomorphic adenoma, one basal cell adenoma, one facial nerve schwannoma), and in one case with a chronic inflammatory lesion (chronic sialadenitis). In no case was facial nerve paralysis or Frey's syndrome noticed after this approach. For the two malignant tumors, there was no evidence of recurrence or metastasis at 2-year and 2.5-year follow-ups. Six of the seven patients were fully satisfied with the cosmetic results of surgery. The remaining patient had a mild sunken deformity of the midcheek where the mass had been located. To manage midcheek masses we modified the standard parotidectomy approach. This new surgical strategy, which we named the parotidotomy approach, provides surgically safe and cosmetically excellent results for midcheek masses.

Pleomorphic Adenoma Causing Facial Nerve Palsy

Facial nerve palsy due to the benign parotid tumor is extremely rare. The authors experienced a case of pleomorphic adenoma in parotid gland, showing retrograde extension to mastoid bone along the facial nerve, resulting facial nerve palsy. An 82-year-old woman with facial nerve palsy for six years was revealed to have a solid mass in the close proximity to mastoid tip with contrast enhancement on computed tomography (CT). The mass extended into the air cells of temporal bone at the exiting site of the facial nerve through stylomastoid foramen. Based on the CT findings and her facial nerve palsy, initial diagnosis was facial nerve schwannoma. Mass was removed via transmastoid approach. The pathology was pleomorphic adenoma and direct nerve invasion was not observed.

Diagnosis of Facial Nerve Schwannoma by Magnetic Resonance Imaging Enhancement of the Geniculate Ganglion

diagnosis of facial nerve schwannoma was based on this enhancement pattern. The patient had a retromastoid craniotomy and intentional subtotal tumor resection. Intraoperatively, the normal-appearing portion of the right facial nerve was identified and noted to be contiguous with the tumor. The pathologicdiagnosiswasschwannoma.No operative complications occurred. Ten months postoperatively, the patient had radiosurgery of the residual tumor. One year after radiosurgery, the patient had full facial sensation, no eye dryness, and mild facial asymmetry. Follow-up imaging showed that the residual tumor had decreased in size (Figure 2), and the patient has returned to work. COMMENT

Schwannoma del nervio facial como diagnóstico diferencial de tumor parotídeo: Reporte de un caso

Facial nerve Schwannoma resembling a parotid tumor. Case report Facial nerve Schwannomas are benign tumors that originate from Schwann cells, with a slow and predictable growth, and that are generally asymptomatic. Only 9% of these tumors are located in the intraparotid segment of the facial nerve. We report a 26 years old female presenting with a mass in the left parotid region lasting four months. The patient was subjected to a parotidectomy. During surgery, an encapsulated tumor whose origin was in the seventh cranial nerve and associated to a lymph node was found. The tumor was excised, trying to preserve the integrity of the nerve. The pathological diagnosis of the surgical piece disclosed a benign Schwannoma. The patient had a facial paralysis in the postoperative period.

Facial nerve schwannoma

The purpose of this review is to summarize the current literature on facial nerve schwannoma and make practical recommendations based on best practices for the management of this difficult but benign neoplasm. Facial nerve schwannoma can be asymptomatic or can present with progressive or acute facial nerve palsy. Associated otological symptoms such as conductive and/or sensorineural hearing loss can occur. The tumor is usually slow-growing and can involve multiple segments of the nerve. Radiographic imaging and facial nerve electrical testing can be helpful in treatment planning. Options for management can include observation, decompression, stripping, resection with grafting, and possibly radiotherapy. Future adjunctive therapies to improve facial nerve function may include electrical stimulation, steroid hormones, and possibly stem cell therapy. Treatment of facial schwannoma is individualized based on patient symptoms, history, and clinicoradiographic evaluation. Not all patients require surgery. As the tumor can involve multiple segments of the nerve, the surgeon attempting removal should be familiar with modern neurotological surgical techniques. Ongoing translational research will hopefully allow us to decrease facial nerve morbidity in these patients.

Magnetic resonance imaging of facial nerve schwannoma

This study characterizes the magnetic resonance (MR) appearances of facial nerve schwannoma (FNS). We hypothesize that the extent of FNS demonstrated on MR will be greater compared to prior computed tomography studies, that geniculate involvement will be most common, and that cerebellar pontine angle (CPA) and internal auditory canal (IAC) involvement will more frequently result in sensorineural hearing loss (SNHL). Retrospective study. Clinical, pathologic, and enhanced MR imaging records of 30 patients with FNS were analyzed. Morphologic characteristics and extent of segmental facial nerve involvement were documented. Median age at initial imaging was 51 years (range, 28-76 years). Pathologic confirmation was obtained in 14 patients (47%), and the diagnosis reached in the remainder by identification of a mass, thickening, and enhancement along the course of the facial nerve. All 30 lesions involved two or more contiguous segments of the facial nerve, with 28 (93%) involving three or more segments. The median segments involved per lesion was 4, mean of 3.83. Geniculate involvement was most common, in 29 patients (97%). CPA (P = .001) and IAC (P = .02) involvement was significantly related to SNHL. Seventeen patients (57%) presented with facial nerve dysfunction, manifesting in 12 patients as facial nerve weakness or paralysis, and/or in eight with involuntary movements of the facial musculature. This study highlights the morphologic heterogeneity and typical multisegment involvement of FNS. Enhanced MR is the imaging modality of choice for FNS. The neuroradiologist must accurately diagnose and characterize this lesion, and thus facilitate optimal preoperative planning and counseling.

Diagnosis and management of intraparotid facial nerve schwannoma

Our objective was to provide the management guidelines for facial nerve schwannomas (FNSs) presenting as a parotid mass. The study is a case report and literature review. Four clinical cases of patients with an asymptomatic parotid mass diagnosed as FNS are presented. The patient's presentation, the diagnostic algorithm and surgical rationale are discussed. A review of the literature on FNSs is presented. Intraparotid FNSs are an extremely rare entity and are rarely diagnosed preoperatively. Intraoperatively, conservative biopsy in a non-functional part of the lesion can be used to make the diagnosis. Most of the FNSs of patients with normal facial nerve function could be dissected off the nerve trunk without losing FN function. FNS patients with preoperatively abnormal FN function should be managed conservatively or undergo reconstruction with nerve graft after tumour resection.

Facial nerve schwannoma

An uncommon case of bilobed facial nerve schwannoma and its management is presented. F a c i a l nerve schwannorna is an uncommon condition and accounts for 5% of all cases of facial paralysis 2,3. These tumours present variedly with otological symptmos, facial paralysis, a mass in the middle ear or a parotid mass. Symptoms are slowly progressive and diagnosis is often delayed. A high index of suspicion combined with modern imaging techniques is essential to diagnose this condition early so that facial nerve function can be preserved.

Chondromyxoid fibroma of the mastoid facial nerve canal mimicking a facial nerve schwannoma

Chondromyxoid fibroma of the skull base is a rare entity. Involvement of the temporal bone is particularly rare. We present an unusual case of progressive facial nerve paralysis with imaging and clinical findings most suggestive of a facial nerve schwannoma. The lesion was tubular in appearance, expanded the mastoid facial nerve canal, protruded out of the stylomastoid foramen, and enhanced homogeneously. The only unusual imaging feature was minor calcification within the tumor. Surgery revealed an irregular, cystic lesion. Pathology diagnosed a chondromyxoid fibroma involving the mastoid portion of the facial nerve canal, destroying the facial nerve.