Intraparotid Facial Nerve Schwannoma Research Articles

Intraparotid Facial Nerve Schwannoma - A Case Report

Abstract Rationale: Intraparotid facial nerve schwannoma (IPFNS) is a rare entity. Diagnosing these tumours is challenging as multiple differential diagnoses exist for swellings in the infraauricular region. Delay in diagnosis can lead to adverse outcomes. Patient Concerns: A 27-year-old female presented with swelling over the left infraauricular region, which concerned her cosmetic appearance. Diagnosis: It was initially misdiagnosed with imaging techniques computerised tomography (CT scan) and fine-needle aspiration cytology, leading to a diagnostic dilemma. Treatment: Superficial parotidectomy was planned and intraoperatively, a cystic lesion was seen adherent to the temporal branch of the facial nerve, which was resected along with the nerve branch. Histopathology confirmed the diagnosis as facial nerve schwannoma. Outcomes: The patient’s cosmetic concern was resolved but there was loss of wrinkles over the ipsilateral forehead region. No recurrence was seen. Take-Away Lessons: IPFNS often causes a diagnostic dilemma and an appropriate and timely diagnosis is required to decrease the morbidity and undertreatment.

Intraparotid Facial Nerve Schwannoma Masquerading as Complicated Otitis Media: A Diagnostic Dilemma

Intraparotid Facial Nerve Schwannoma Masquerading as Complicated Otitis Media: A Diagnostic Dilemma

CASE REPORT OF INTRAPAROTID FACIAL NERVE SCHWANNOMA

Schwannoma is a rare, benign, slow growing tumor originating from Schwann cells or nerve sheaths. Facial nerve Schwannomas are usually intratemporal with extratemporal being only 9% cases. Facial palsy is usually seen in patients with Intratemporal facial nerve Schwannomawhereas patients with Intraparotid Facial Schwannomas usually present with a slow growing parotid region swelling without any facial palsy. Hence, differentiation of Intraparotid Facial Nerve Schwannoma from other Benign tumors involving the parotid gland is difficult.This is a case report of a 57 year old male patient who presented to the ENT OPD of HBTMC & Dr. R.N. Cooper Hospital, Mumbai with Right Parotid region swelling who underwent surgery for the same with histopathology report suggestive of Facial Nerve Schwannoma.

Intraparotid facial nerve schwannoma: a challenge in diagnosis and management

Intraparotid facial nerve schwannoma: a challenge in diagnosis and management

Intracapsular Enucleation of Intraparotid Facial Nerve Schwannoma with Intratemporal Extension.

Intraparotid facial nerve schwannoma is a rare condition, which is difficult to preoperatively diagnose without a definite biopsy, yet the diagnosis is important for surgical planning and avoiding accidental injury to the facial nerve. Considering the benign indolent nature of the schwannomas, the management should be prioritized on the long-term tumor control with special attention to the facial nerve function and facial cosmesis. Microscope-assisted intracapsular enucleation is an excellent treatment option for such lesions. Our patient showed House–Brackmann grade II facial function after the surgery. This technique is safe and offers a favorable outcome of facial nerve function.

Systematic Review of Intra Parotid Facial Nerve Schwannoma and a Case Report.

To evaluate the clinico-epidemiological aspects, pathological features, diagnostic methods, management protocol and functional outcome of the intra-parotid facial nerve schwannoma (IFNS) and to present a case report on intra parotid facial nerve schwannoma. PubMed, ProQuest, Google scholar, Science direct and Scopus were screened for studies. Article selection and data extraction was done by one investigator and other investigator confirmed its accuracy. After abstract and text screening a total of 69 articles were finally selected for the study with the inclusion and exclusion criteria of the systematic review as per PRISMA guidelines. With addition of one case reported to our department. The mean age of diagnosis was 43 ± 16years with a slight female predominance. The mean duration of the tumour was 29.5months and the mean size of the tumour on initial diagnosis was 3.6 ± 1.67cm. Pleomorphic adenoma was the primary diagnosis in 44 cases. Superficial parotidectomy was done in 64 cases followed by resection in 47 cases. Reconstructive treatment was carried out by an end-to-end anastomosis in 3 patients and by facial-hypoglossal anastomosis in 16 patients, GAN cable grafting in 5 patients, a greater auricular nerve graft was done in18 patients and end-to-side interposed sural nerve graft in 8 patients. The type D tumours are treated by extended resection of the facial nerve, which is difficult to reconstruct and also employs a nerve graft that does not often give acceptable recovery of facial function. Facial nerve schwannomas being a rare entity poses a dilemma in diagnosis and management. Managing the lesions is also difficult as intraoperative adherence to the nerve makes a tumour free margin difficult without sacrificing the nerve. At present there is no consensus regarding the management of various types of intra-parotid facial nerve shwannoma.

Intraparotid Facial Nerve Schwannoma: A Report of Two Cases

ABSTRACT Schwannoma is a benign, asymptomatic, solitary, and encapsulated tumor that grows slowly from peripheral, autonomic, or cranial nerve sheaths. The origin of the schwannomas in the facial nerve is rare and they tend to occur in the intratemporal part of the nerve. An intraparotid facial nerve schwannoma is usually a painless, slow-growing mass like the other benign parotid tumors. In this case report, we will discuss the clinical presentation, management, and outcome of two patients with intraparotid facial nerve schwannoma. How to cite this article: Topuz MF, Genç O, Kadioglu N, et al. Intraparotid Facial Nerve Schwannoma: A Report of Two Cases. Int J Otorhinolaryngol Clin 2020;12(1):4–7.

Intraparotid facial nerve schwannoma: A cross-country report of two cases and literature review

Intraparotid facial nerve schwannoma: A cross-country report of two cases and literature review

Analysis of clinical diagnosis and treatment of 12 cases of intraparotid facial nerve schwannoma

Objective: To investigate the clinical manifestation and management strategy of intraparotid facial nerve schwannoma. Methods: The clinical data of 12 patients with parotid schwannoma treated in Henan Cancer Hospital from January 2009 to January 2019 were analyzed retrospectively, including 5 males and 7 females, aged from 23 to 72 years. All the 12 patients complained of a mass in the parotid region, of whom 4 patients had local discomfort and pain, and 6 patients had varying degrees of pain during palpation. Ultrasound examination showed solid mass in parotid region in 8 cases and mixed mass in 4 cases. The treatment methods, the relationship between tumor and facial nerve, the modes of treatments and the nerve functions before and after operation were analyzed and summarized with House-Brackmann grade. Results: All 12 patients received surgical treatment: 8 patients underwent tumor resection plus partial or total superficial parotidectomy, 1 patient underwent tumor resection and total parotidectomy, and 3 patients underwent tumor resection, with 1 patient in whom tumor could not be removed completely due to tumor extention to the skull base. In 9 cases, the tumor occurred in the trunk or main branch of the facial nerve, and there was no facial nerve injury occurred after surgery; in 1 case, the tumor occurred in the terminal branch of the facial nerve, and part of the severe small branches of adhesion were cut off during the operation; in 1 case, the total trunk of the facial nerve was not found and the broken end of the nerve could not be found during the operation, so the nerve transplantation was not performed. In 1 case, nerve grafting was performed after nerve transection because it was impossible to separate the trunk of the facial nerve from the tumor during the operation. Preoperatively, House-Brackmann grade (H-B)Ⅰfacial nerve function was shown in 10 patients, H-BⅡ in 1 patient and H-B Ⅴin 1 patient. Postoperatively, the facial nerve function recovered to H-B Ⅰfor 7 patients, H-B Ⅱfor 2 patients, H-B Ⅲ for 1 patient, grade Ⅳ for 1 patient with nerve transplantation, and H-B Ⅴfor 1 patient with a revised surgery due to tumor recurrence. Conclusions: The intraparotid facial nerve schwannoma is rare, and it is easy to be misdiagnosed before operation. Surgery is a main treatment for intraparotid facial nerve schwannoma. Attention should be paid to the protection of facial nerve during operation.

An Intraparotid Schwannoma Mimicking A Warthin’s Tumour

In this report, we describe the rare presentation of a cystic intraparotid facial nerve schwannoma (IPFNS) in a young female who initially presented with a painful unifocal parotid mass gradually enlarging over 5 years. Preliminary imaging and cytology offered this to be a Warthin’s tumour. Here we describe the limitations of current diagnostic tools in the workup of intraparotid cystic lesions and highlight the importance of keeping rare tumours in mind to optimize pre-­surgical management.

Facial palsy due to intraparotid schwannoma invading the stylomastoid foramen

Intraparotid facial nerve schwannomas are rare and facial palsy because of them is even rarer. They should be kept in the differential diagnosis of parotid swellings, though preoperatively they are difficult to diagnose. We herein report a case of 30-year-old female who presented with left-sided massive preauricular swelling with facial nerve palsy, on computed tomography, there was invasion and widening of the stylomastoid foramen. This mass was diagnosed as pleomorphic adenoma on fine-needle aspiration cytology and came out to be schwannoma on histopathological examination.

Intraparotid facial nerve schwannoma: a 17-year, single-institution experience of diagnosis and management

Background: Intraparotid facial nerve schwannoma (IFNS) is rare and its definite preoperative diagnosis is challenging.Objective: To improve available knowledge regarding the diagnosis of IFNS and to suggest an appropriate treatment plan.Material and methods: We retrospectively analyzed medical records of IFNS patients at our hospital. Inclusion criteria were surgery (from January 2000, to December 2016) for a parotid mass, pathologically diagnosed as a schwannoma.Results: The study included 42 eligible patients who had undergone tumor resection from 5977 parotid tumor patients. Mostly presented hard-textured (18/39) or medium-textured (15/39), with limited mobility (21/39) mass (three tumors were not palpable). Their facial nerve function outcomes were House–Brackmann Grade I (n = 14), Grade II (n = 7), Grade III (n = 11), Grade IV (n = 5), Grade V (n = 3), and Grade VI (n = 2). Significant differences were noted in results based on different surgical methods used (p = .000) and tumor involvement (p = .002).Conclusions and significance: A hard-textured tumor with limited mobility mass in the parotid gland should prompt the diagnosis of a schwannoma. Tumors involving main trunk usually lead to unsatisfactory facial nerve outcomes. Facial nerve preservation should always be essential, and stripping surgery or intracapsular enucleation could be the preferred surgical methods of choice.

Intraparotid facial nerve schwannomas.

Schwannoma is a benign tumor rarely found in the head and neck and much less commonly found in the intraparotid facial nerve. It is a slow-growing encapsulated tumor originating from the Schwann cells or axonal nerve sheath. It can occur anywhere along the course of the facial nerve. Patients may present with symptoms of facial palsy, but the most common presenting symptom is an asymptomatic swelling. Diagnosis is usually difficult before surgical removal and histopathological examination. We report a rare case of intraparotid facial nerve schwannoma in a 57-year-old female who had sustained a mass of the right preauricular area for 3 years. She reported no pain or facial muscle weakness. Enhanced computed tomography findings revealed the impression of pleomorphic adenoma. However, intraoperative gross findings were not characteristic of pleomorphic adenoma, and a frozen biopsy was performed resulting in the impression of a nerve sheath tumor. We performed an extracapsular surgical excision without parotidectomy. Permanent histopathology and immunohistochemistry reports diagnosed the mass as schwannoma. There were no complications including facial palsy after surgery. No recurrence was found at 6 months after surgery

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

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

Schwanomma of the parotid gland and its presentation

Our objective is to present a very rare clinical case of intraparotid facial nerve schwannoma that clinically presented as an asymptomatic parotid tumor, cystic neoplasm of the left parotid gland and was diagnosed after histopathology as schwanomma of the facial nerve. Another purpose is to discuss diagnostic possibilities, appropriate planning for the management and predictive outcomes of surgical management. A clinical case of a patient with an asymptomatic parotid mass diagnosed as a facial nerve schwannomaintraoperatively is presented. The patient’s presentation and the diagnostic procedures, surgery and the follow up procedures are discussed. Intraparotid facial nerve schwannoma is an extremely rare entity and rarely diagnosed preoperatively. Management of intraparotid facial nerve schwannomas (IFNS) is very challenging because the diagnosis is often made intraoperatively and in most cases resection can lead to severe facial nerve (FN) paralysis with significant aesthetic consequences. Imaging studies and fine-needle aspiration cytology are not always helpful in preoperative diagnosis.

Radical intracapsular microenucleation technique for exclusively intraparotid facial nerve schwannoma: Long-term follow-up review.

To evaluate the efficacy and long-term outcome of radical intracapsular microenucleation technique for the treatment of exclusively intraparotid facial nerve schwannoma (IFNS). From 1996 to 2015, IFNSs closely adherent to the facial nerve without intratemporal involvement were selected for this study. IFNSs were subdivided into an intracapsular microenucleation group and a resection with reconstruction group. Facial nerve function was assessed using the House-Brackmann Grading system. The study sample consisted of 28 patients who were followed up for 5.75 years (range, 1-15 years). Of the 28 patients, 18 IFNSs were from the main trunk. Radical intracapsular microenucleation was performed in 9 patients, resection with reconstruction in 7 patients, and only biopsy in 2 patients. Nine patients who received intracapsular microenucleation recovered to House-Brackmann Grade I (55.6%) or Grade II (44.4%), in comparison to the 7 patients from resection group (Grade III, 28.6%; Grade IV, 42.9%; Grade V, 28.6%). The other 10 IFNSs from the distal branches maintained favorable nerve function with either of the treatments. Tumor recurrence was not observed except for the two patients with only biopsy. Radical intracapsular microenucleation with nerve preservation was a safe and reliable treatment for IFNS, especially for the IFNS from the main trunk.

Clinical Retrospective Analysis of 9 Cases of Intraparotid Facial Nerve Schwannoma

The management of intraparotid facial nerve schwannoma (IFNS) is challenging because it is extremely rare and often misdiagnosed as pleomorphic adenoma or another parotid tumor. The purpose of this study was to report on the authors' experience in the treatment of IFNS and to review the literature regarding the diagnosis and management of IFNS. From January 1997 through October 2015, 916 consecutive parotidectomies were performed at Shenzhen People's Hospital (Shenzhen, China). Of 916 parotid tumors samples, 9 cases of IFNS confirmed by histopathology were identified and analyzed retrospectively. In addition, 161 published cases from 1956 through 2015 were systematically reviewed. Nine cases of IFNS were identified from 916 parotid tumors samples and accounted for 0.98% of all parotid tumors. All these patients with IFNS underwent tumor removal and parotidectomy with preservation of facial nerve (FN) continuity. The mean follow-up period was 6.2years (range, 1 to 16yr). Facial function improved gradually from House-Brackmann grade (HBG) II to III immediately postoperatively to HBG I during the subsequent 3 to 9months in all cases. Tumor recurrence with stylomastoid foramen involvement was observed in 1 case 3years after surgery. The others remained free of recurrence. Of 161 IFNS cases reported in the literature, 17 cases with facial paresis were found to have intra-temporal involvement, but no facial paresis was found in patients with intraparotid involvement only. An IFNS is easily misdiagnosed as pleomorphic adenoma or Warthin tumor preoperatively; the correct diagnosis for IFNS depends mainly on intraoperative observation of the gross relation between the tumor and the FN or excision frozen biopsy examination. The integrity of the FN should be preserved for patients with IFNS and without facial paresis, whenever possible.

Intraparotid facial nerve schwannoma in a 12-year-old child. Report of a case and review of the literature

Abstract Schwannomas are benign tumors originating from Schwann cells. The appearance of these tumors in the intraparotid segment of the facial nerve is rare and is observed almost exclusively in adults. We report a case of an intraparotid facial nerve schwannoma in a 12-year-old patient, who presented with a well-defined parotid enlargement and normal facial nerve function. Surgical intervention consisted of parotidectomy with preservation of the facial nerve. A review of the literature is reported.

Intraparotid facial Nerzve Schwannoma : A rare case report

Intraparotid facial nerve schwannomas are extremely rare neoplasm that presents challenge in diagnosis and management as they are rarely diagnosed preoperatively. We sought to gain insight into clinical presentation, appropriate diagnostic and management modalities which is a matter of debate. Here we present a rare case of intraparotid facial nerve schwannomas diagnosed intra-operatively and managed with surgical excision.

Intraparotid Facial Nerve Schwannoma.

Intraparotid facial nerve schwannoma is a rare benign neoplasm. Due to its rarity, it is not usually a prioritized diagnosis before surgery and may therefore lead to an unintentional treatment error. In this article, we report a single case of intraparotid facial nerve schwannoma. We were able to make a diagnosis with frozen biopsy. A complete resection of the mass while preserving the facial nerve was performed. Herein we present our clinical experience with regards to the treatment process of intraparotid facial nerve schwannoma.