Management options for intraparotid facial nerve schwannoma

Abstract

Conclusion: Limited intraparotid facial nerve schwannoma (IFNS) and IFNS with intratemporal involvement should be managed separately because of their different characteristics. Limited IFNS with House–Brackman (HB) grade ≤ II should undergo tumor removal only if it can be resected easily off the nerve. For IFNS with intratemporal involvement and a HB grade ≤ II, a conservative treatment (i.e. wait-and-see alone, or bone decompression) is recommended. Objective: To provide management options for IFNS. Methods: From 1996 to 2011, seven cases of IFNS underwent surgical treatment. Clinical and radiologic findings, surgical approach, and preoperative and postoperative facial nerve function were analyzed retrospectively. Results: Three IFNSs extended into the mastoid (43%). Two of the three patients with mastoid extension progressed to HB grade IV after the operation because the facial nerve was sacrificed, whereas the other one who underwent biopsy and decompression remained at HB grade II. Four limited IFNSs (57%) presented with grades I–II, three of which were removed while preserving facial nerve function and the other was removed by cystic decompression. No recurrence or significant growth of the non-resected schwannoma was observed.

Keywords::

• Facial nerve
• parotid
• neuroma

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.