Skip to main content

Facial Nerve Schwannomas

  • Chapter
  • First Online:
Samii's Essentials in Neurosurgery

Abstract

Following vestibulocochlear and trigeminal nerve, facial nerve schwannomas (FNSs) are the third most frequent primary tumor that is associated with the cranial nerves. FNSs are uncommon tumors, extremely slow growing, benign in the majority of cases, and frequently present without facial dysfunction. They can be mistaken for vestibular schwannomas. The tumor arises from Schwann cells in a focal manner as a solitary and well-encapsulated mass. They can arise at the cerebellopontine angle (CPA), internal meatus, geniculate ganglion, and peripheral nerves in the mastoid bone or in the muscle (Fig. 22.1). The most common sites are the geniculate ganglion and internal auditory canal. Malignant FNSs are extremely rare. This study reviews the surgical anatomy, the clinical presentations, the radiological diagnosis, the appropriate planning for the management, the surgical approaches, and the predictive outcomes of surgical management. Surgery is clearly indicated when the patient presents already facial nerve palsy. If the facial function is normal and the tumor is not compressing the brain stem, a conservative management is considered.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Angeli S, Brackmann DE (1997) Is surgical excision of facial nerve schwannomas always indicated? Otolaryngol Head Neck Surg 117:144–147

    Article  Google Scholar 

  2. Biggs ND, Fagan PA (2001) Schwannomas of the chorda tympani. J Laryngol Otol 115:50–52

    Article  CAS  PubMed  Google Scholar 

  3. Chung JW, Ahn JH, Kim JH (2004) Facial nerve schwannomas: different manifestations and outcomes. Surg Neurol 62:245–252

    Article  PubMed  Google Scholar 

  4. Dort JC, Fisch U (1991) Facial nerve schwannomas. Skull Base Surg 1:51–56

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Fenton JE, Morrin MM, Smail M, Sterkers O, Sterkers JM (1999) Bilateral facial nerve schwannomas. Eur Arch Otorhinolaryngol 256:133–135

    Article  CAS  PubMed  Google Scholar 

  6. Janecka IP, Sekhar LN (1993) Facial nerve neurilemomas. In: Sekhar LN, Janecka IP (eds) Surgery of cranial base tumors. Raven, New York, pp 725–730

    Google Scholar 

  7. Kida Y, Yoshimoto M, Hasegawa T (2007) Radiosurgery for facial schwannoma. J Neurosurg 106(1):24–29

    Article  PubMed  Google Scholar 

  8. Lee WS, Kim J (2011) Revised surgical strategy to preserve facial function after resection of facial nerve schwannoma. Otol Neurotol 32(9):1548–1553

    Article  PubMed  Google Scholar 

  9. Lee JD, Kim SH, Song MH, Lee HK, Lee WS (2007) Management of facial nerve schwannoma in patients with favorable facial function. Laryngoscope 117(6):1063–1068

    Article  PubMed  Google Scholar 

  10. Lipkin AF, Coker NJ, Jenkins HA, Alford BR (1987) Intracranial and intratemporal facial neuroma. Otolaryngol Head Neck Surg 96:71–79

    CAS  PubMed  Google Scholar 

  11. Liu R, Fagan P (2001) Facial nerve schwannoma: surgical excision versus conservative management. Ann Otol Rhinol Laryngol 110:1025–1029

    CAS  PubMed  Google Scholar 

  12. Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D (2005) Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg 102:195–199

    Article  PubMed  Google Scholar 

  13. Magliulo G, DĂ¡mico R, Vacaralli S, Ciniglio-Appiani G (2000) Chorda tympani neuroma: diagnosis and management. Am J Otolaryngol 21:65–68

    Article  CAS  PubMed  Google Scholar 

  14. Marzo SJ, Zender CA, Leonetti JP (2009) Facial nerve schwannoma. Curr Opin Otolaryngol Head Neck Surg 17(5):346–350

    Article  PubMed  Google Scholar 

  15. McMonagle B, Al-Sanosi A, Croxson G, Fagan P (2008) Facial schwannoma: results of a large case series and review. J Laryngol Otol 122(11):1139–1150

    Article  CAS  PubMed  Google Scholar 

  16. Minovi A, Vosschulte R, Hofmann E, Draf W, BockmĂ¼hl U (2004) Facial nerve neuroma: surgical concept and functional results. Skull Base 14:195–200

    Article  PubMed Central  PubMed  Google Scholar 

  17. Mowry S, Hansen M, Gantz B (2012) Surgical management of internal auditory canal and cerebellopontine angle facial nerve schwannoma. Otol Neurotol 33(6):1071–1076

    PubMed  Google Scholar 

  18. O’Donoghue GM, Brackmann DE, House JW, Jackler RK (1989) Neuromas of the facial nerve. Am J Otol 10:49–54

    PubMed  Google Scholar 

  19. Okabe Y, Nagayama I, Takiguchi T, Furukawa M (1992) Intratemporal facial nerve neurinoma without facial nerve paralysis. Auris Nasus Larynx 19:223–227

    Article  CAS  PubMed  Google Scholar 

  20. Perez R, Chen JM, Nedzelski JM (2005) Intratemporal facial nerve schwannoma: a management dilemma. Otol Neurotol 26(1):121–126

    Article  PubMed  Google Scholar 

  21. Pillsbury HC, Price HC, Gardiner LJ (1983) Primary tumors of facial nerve. Laryngoscope 93:1045–1048

    Article  CAS  PubMed  Google Scholar 

  22. Pollock BE, Kondziolka D, Flickinger JC, Maitz A, Lunsford LD (1993) Preservation of cranial nerve function after radiosurgery for nonacoustic schwannomas. Neurosurgery 33:597–601

    Article  CAS  PubMed  Google Scholar 

  23. Proctor B (1989) Canals of the temporal bone. In: Anson BJ, Donaldson JA (eds) Surgical anatomy of the ear and temporal bone. Thieme Stratton, New York, pp 89–128

    Google Scholar 

  24. Pulec JL (1994) Facial nerve neuroma. Ear Nose Throat J 73:721–752

    CAS  PubMed  Google Scholar 

  25. Rhoton AL Jr, Hall GM (1968) Absence of bone over the geniculate ganglion. J Neurosurg 28:48–53

    Article  PubMed  Google Scholar 

  26. Saada AA, Limb CJ, Long DM, Niparko JK (2000) Intracanalicular schwannoma of the facial nerve: a manifestation of neurofibromatosis type 2. Arch Otolaryngol Head Neck Surg 126(4):547–549

    Article  CAS  PubMed  Google Scholar 

  27. Saito H, Baxter A (1972) Undiagnosed intratemporal facial nerve neurilemmomas. Arch Otolaryngol 95(5):415–419

    Article  CAS  PubMed  Google Scholar 

  28. Sataloff RT, Frattali MA, Myers DL (1995) Intracranial facial neuromas: total tumor removal with facial nerve preservation: a new surgical technique. Ear Nose Throat J 74:244–256

    CAS  PubMed  Google Scholar 

  29. Sherman JD, Dagnew E, Pensak ML, van Loveren HR, Tew JM Jr (2002) Facial nerve neuromas: report of 10 cases and review of the literature. Neurosurgery 50:450–456

    PubMed  Google Scholar 

  30. Stasolla A, Bellussi A, Bibbolino C (2006) Dural tail: another face of facial nerve schwannoma? AJNR Am J Neuroradiol 27:1804

    PubMed  Google Scholar 

  31. Tanbouzi Husseini S, Piccirillo E, Taibah A, Paties CT, Rizzoli R, Sanna M (2011) Malignancy in vestibular schwannoma after stereotactic radiotherapy: a case report and review of the literature. Laryngoscope 121(5):923–928

    Article  PubMed  Google Scholar 

  32. Wiggins RH 3rd, Harnsberger HR, Salzman KL, Shelton C, Kertesz TR, Glastonbury CM (2006) The many faces of facial nerve schwannoma. AJNR Am J Neuroradiol 27:694–699

    PubMed  Google Scholar 

  33. Wilkinson EP, Hoa M, Slattery WH III, Fayad JN, Friedman RA, Schwartz MS, Brackmann DE (2011) Evolution in the management of facial nerve schwannoma. Laryngoscope 121:2065–2074

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ricardo Ramina MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Ramina, R., Neto, M.C., da Silva, E.B., Vosgerau, R., Fernandes, Y.B., do Rego Monteiro, F.M. (2014). Facial Nerve Schwannomas. In: Ramina, R., de Aguiar, P., Tatagiba, M. (eds) Samii's Essentials in Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54115-5_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54115-5_22

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54114-8

  • Online ISBN: 978-3-642-54115-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics