Facial Nerve Schwannoma: The Rare/Great Mimicker of Vestibular Schwannoma/Neuroma

Deepthi, P. R.; Barla, Kiran; Dayal, Monal; Gati, Rajitha; Lakota, Praveen Kumar

doi:10.1055/s-0041-1734356

Cited by 9 publications

(14 citation statements)

References 12 publications

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“…FNS is rare, accounting for less than 1% of all temporal bone tumors [ 9 ]. It originates from the Schwann cell, confines within a capsule and stays at the periphery of the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

Acute Facial Nerve Palsy in Facial Nerve Schwannoma Following COVID-19 Infection

Ridzam¹,

Abdullah²

2023

Cureus

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Lower motor neuron facial nerve palsy (FNP) has many causes. Bell's palsy is by far the commonest cause. Among other causes include infective and neoplastic causes. While FNP caused by facial nerve schwannoma (FNS); a benign neoplastic condition of the facial nerve is slowly progressing, infective causes mainly viral origins present with acute FNP. We present a young female who complained of an acute onset of FNP on day five of her COVID-19 infection. She initially presented with symptoms suggestive of ear infection, and subsequent magnetic resonance imaging (MRI) showed evidence of FNS, which she was subjected to surgery later at our center. This rare acute incidence of FNP in schwannoma might be triggered by the COVID-19 infection and demonstrates the role of imaging in finding the cause of FNP.

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“…FNS is rare, accounting for less than 1% of all temporal bone tumors [ 9 ]. It originates from the Schwann cell, confines within a capsule and stays at the periphery of the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

Acute Facial Nerve Palsy in Facial Nerve Schwannoma Following COVID-19 Infection

Ridzam¹,

Abdullah²

2023

Cureus

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“…Facial nerve schwannomas were differentiated from vestibular nerve schwannomas by intraoperative findings or by neurological features and radiologic characteristics. 1,3 Facial nerve schwannoma patients had more facial nerve function deficits along with tumor involvement of the temporal bone or extra temporal segments. 3 All imaging was reviewed by experienced neuroradiologists, as well as radiosurgical teams practicing at tertiary or quaternary referral centers.…”

Section: Patient Populationmentioning

confidence: 99%

“…1,3 Facial nerve schwannoma patients had more facial nerve function deficits along with tumor involvement of the temporal bone or extratemporal segments. 3 All imaging was reviewed by experienced neuroradiologists, as well as radiosurgical teams practicing at tertiary or quaternary referral centers. If there is any doubt about the diagnosis of a facial schwannoma, the patient was excluded from the study.…”

Section: Patient Populationmentioning

confidence: 99%

“…Vestibular nerve schwannomas are the most common cranial nerve (CN) schwannomas, followed by trigeminal nerve and facial nerve schwannomas, respectively. 3 Patients with facial nerve schwannomas may present with a diverse clinical picture, making diagnosis based on imaging and clinical findings alone difficult. Due to their rarity, a welldefined management protocol for facial nerve schwannomas particularly those not requiring urgent decompressive surgery has not been fully defined.…”

Section: Introductionmentioning

confidence: 99%

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Facial Nerve Schwannoma Treatment with Stereotactic Radiosurgery (SRS) versus Resection followed by SRS: Outcomes and a Management Protocol

Dayawansa

Dumot

Mantziaris

et al. 2022

J Neurol Surg B Skull Base

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Background: Stereotactic radiosurgery (SRS) and resection are treatment options for patients with facial nerve schwannomas without mass effect. Objective: To evaluate outcomes of patients treated with SRS Vs resection+SRS. Method: We retrospectively compared 43 patients treated with SRS to 12 patients treated with resection+SRS. The primary study outcome was unfavorable combined endpoint, defined as worsening or new clinical symptoms, and/or tumor radiological progression. SRS (38.81+ 5.3) and resection+ SRS (67.14+ 11.8) groups had similar clinical follow ups. Results: At the time of SRS, the tumor volumes of SRS (mean+ standard error; 1.83cc+ 0.35CC) and resection+ SRS (2.51cc+ 0.75CC) groups were similar. SRS (12.15+0.08 Gy) and resection+ SRS (12.16+ 0.14 Gy) groups received similar radiation doses. SRS group (42/43, 98%) had better local tumor control than the resection+SRS group (10/12, 83%, p=0.04). Most of SRS (32/43, 74%) and resection+SRS (10/12, 83%) group patients reached a favorable combined endpoint following SRS (P=0.52). Considering surgical associated side effects, only 2/10 patients of resection+SRS group reached a favorable end point (P<0.001). Patients of SRS group, who are >34 years old (p=0.02), have larger tumors (>4cc, 0.04), internal auditory canal (IAC) segment tumor involvement (p=0.01) were more likely to reach an unfavorable endpoint. Resection+SRS group patients did not show such a difference. Conclusions: While resection is still needed for larger tumors, SRS offers better clinical and radiological outcomes compared to resection followed by SRS for facial schwannomas. Younger age, smaller tumors, and non-IAC situated tumors are factors that portend a favorable outcome.

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“…2 Although NFN were mostly managed by surgical resection, the timing of surgery is controversial due to the inevitability of post-operative House-Brackman grade III facial palsy. [3][4][5] It has been demonstrated that fractionated stereotactic radiotherapy (FSRT) has been effective for acoustic neuromas of the cerebellopontine angle or internal auditory canal with minimal morbidity. 6 Our purpose is to systematically review the literature about FSRT on the treatment of NFN.…”

Section: Introductionmentioning

confidence: 99%

Management of a facial nerve schwannoma with fractionated stereotactic radiotherapy: a case report

Mousli¹,

Ayadi²,

Yousfi³

et al. 2023

J Radiother Pract

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Introduction: Neuroma of the facial nerve (NFN) is an extremely rare benign tumour that can involve any segment of the facial nerve. It is revealed by facial weakness with or without hearing loss and has commonly been managed by microsurgery. Our purpose is to systematically review the literature about the role of fractionated stereotactic radiotherapy (FSRT) on the treatment of NFN. Clinical case: We report the case of a 70-year-old-woman who presented progressively worsening facial paralysis associated with mild conductive hearing loss and dizziness. The multimodal magnetic resonance imaging (MRI) was very suggestive of an intrapetrous neuroma, centred on the tract of the VII nerve and the left geniculate ganglion. She was treated by FSRT at the dose of 18 Gy in three fractions on the isodose line 80 %. After 18-month follow-up, she reported a facial weakness improvement. The MRI revealed a stable disease. Conclusion: The clinical presentation of the schwannoma of the facial nerve depends essentially on its location. It is therefore very variable, ranging from an isolated mild hearing loss to a vestibular syndrome with facial paralysis. Through this observation with literature review, we reported a long-term tumour control with improvement of pre-treatment symptomatology with FSRT.

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Facial Nerve Schwannoma: The Rare/Great Mimicker of Vestibular Schwannoma/Neuroma

Cited by 9 publications

References 12 publications

Acute Facial Nerve Palsy in Facial Nerve Schwannoma Following COVID-19 Infection

Acute Facial Nerve Palsy in Facial Nerve Schwannoma Following COVID-19 Infection

Facial Nerve Schwannoma Treatment with Stereotactic Radiosurgery (SRS) versus Resection followed by SRS: Outcomes and a Management Protocol

Management of a facial nerve schwannoma with fractionated stereotactic radiotherapy: a case report

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