Role of MPR image reconstruction in guiding the diagnosis and treatment strategy of facial nerve schwannoma

Abstract

Background

Facial nerve schwannomas tend to be overlooked due to their mild early clinical presentation and slow progression.

Aims/objectives

To describe the role of facial nerve reconstruction in guiding the diagnosis and treatment strategy of facial nerve schwannoma.

Material and methods

Multi-plane reformation (MPR) of the facial nerve was conducted to evaluate the facial nerve lesion segments, radiological characteristics, and mastoid decompression in 13 patients.

Results

Bone canal loss could be seen in lesions involving the geniculate ganglion and tympanic segment and those protruding toward the tympanum in two patients. Expansive space occupying lesions could be seen in the facial nerve involving the tympanic segment to the parotid segment in five patients. A ‘trumpet mouth’ spherical expansive space-occupying lesion centered in the mastoid segment and enlarged stylomastoid foramen could be seen in lesions involving the mastoid segment to the parotid segment in six patients. Treatment methods suitable for the patient were performed based on the facial palsy, tumor size, hearing loss, and social requirements.

Conclusions and significance

Facial nerve MPR reconstruction can comprehensively and intuitively display the lesion segment and area of the facial nerve in the temporal bone, estimate the facial nerve length, bone encapsulation, and mastoid decompression, and has characteristic presentations that can aid preliminary diagnosis and identification.

Chinese Abstract

背景：面神经鞘瘤由于其早期临床表现轻微且进展缓慢而往往被忽视。

目的：描述面神经重建在指导面神经鞘瘤诊断和治疗策略方面的作用。

材料与方法：进行面神经多平面重建（MPR）以评估13 名患者的面神经病变节段、影像学特征和乳突减压。

结果：两名患者膝状神经节、鼓室段及向鼓室突出的病灶均见骨管丢失。五名患者可见累及鼓室段至腮腺段的面神经内的扩张性占位性病变。6 名患者在累及乳突段和腮腺段的病灶内可见以乳突段为中心的“喇叭口”球形扩张性占位性病变和扩大的茎乳孔。根据面瘫、肿瘤大小、听力损失和社会要求, 对患者进行了适合的治疗。

结论及意义：面神经MPR重建可以全面、直观显示颞骨面神经的病变段和面积, 估计面神经长度、骨包裹和乳突减压, 并能表现出有助于初步诊断和鉴别的特征。

Keywords:

• Schwannoma
• facial nerve
• multi-plane reconstruction
• otologic surgery

Disclosure statement

No potential conflict of interest was reported by the author(s).