Intratemporal Schwannoma of the Facial Nerve

Abstract

Two patients with schwannomas that originated from the region of the geniculate ganglion of the facial nerve are reported. They presented with progressive facial nerve paralysis and variable disturbance of hearing. Computed tomograms demonstrated a mass lesion eroding the temporal bone (petrous portion) and extending into the middle fossa. The treatment consisted of complete excision of the tumor, and a hypoglossal-facial nerve anastomosis. Computed tomography should be performed on all patients with facial palsy of a progressive nature. Early diagnosis and surgical treatment of facial schwannoma should permit preservation of function of the facial and the acoustic nerves.

Schwannoma of the greater superficial petrosal nerve

“…In most cases the tumor presents as a mass exiting the distal fallopian canal 2 . In contrast, schwannomas that extend into the intracranial cavity, as in this case, are rare 3 . The initial symptom, which may be the only sign for many years, was a peripheral type of facial paralysis erroneously diagnosed as Bell's palsy 3 .…”

“…2 In contrast, schwannomas that extend into the intracranial cavity, as in this case, are rare. 3 The initial symptom, which may be the only sign for many years, was a peripheral type of facial paralysis erroneously diagnosed as Bell's palsy. 3 Schwannomas can occur anywhere along the course of the facial nerve, but predominantly in the vertical tympanic and the geniculate segments.…”

“…3 The initial symptom, which may be the only sign for many years, was a peripheral type of facial paralysis erroneously diagnosed as Bell's palsy. 3 Schwannomas can occur anywhere along the course of the facial nerve, but predominantly in the vertical tympanic and the geniculate segments. 1 In the presented case, as in other cases, 3 the initial symptom of facial nerve paralysis was followed by hearing loss.…”

“…3 Schwannomas can occur anywhere along the course of the facial nerve, but predominantly in the vertical tympanic and the geniculate segments. 1 In the presented case, as in other cases, 3 the initial symptom of facial nerve paralysis was followed by hearing loss. Interestingly, although the tumor affected the greater petrosal nerve in our case, there was no diminution of lacrimal secretion.…”

Infranuclear Facial Palsy

“…Coronal images are helpful in the evaluation of tumors in this region, and smooth enlargement of the facial nerve canal should be a distinguishing feature in favor of a facial schwannoma. Multisegment facial nerve schwannomas may need to be differentiated from perineural spread of malignant tumor (19). Imaging Findings.…”