To describe the characteristics, diagnosis, management and outcomes of facial nerve schwannomas (FNSs).
Patients whose outpatient diagnosis was facial nerve tumor and whose intraoperative identification was FNS between 2002 and 2012 were studied. Preoperative data (audiologic data, facial nerve [FN] function, and patient symptoms, tumor location on imaging data), intraoperative data (total versus subtotal resection, and FN status), and postoperative data (audiologic data, FN function, and recurrence) were collected.
Surgical removal was performed in 16 patients whose FNS were confirmed histologically and 5 patients decided on follow-up. Facial paralysis and hearing loss presented commonly. The FNS involved mostly the geniculate segment, following internal auditory canal. 16 patients were operated on, of them 14 total resection, and 2 subtotal resection. The translabyrinthine approach was performed in 9 cases, the middle fossa approach was performed in 5 cases of which 1 combined with transmastoid approach, and the TM approach was performed in 2 cases. One-stage facial nerve repair was performed in 11 cases, of them 5 facial-hypoglossal nerve anastomosis and 6 sural nerve graft. These patients showed better facial function (mainly HB grades III–IV). Partial removal kept the facial function at grade II.
The symptoms of FNS are related to its location, the patients complained mainly facial paralysis and hearing loss. MRI is indispensable for the differential diagnosis, subtotal removal may be a better choice for VS-like FNS. One-stage facial repair can give a good FN outcome.
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Publié par Elsevier Masson SAS.