• World Neurosurg · Apr 2017

    Review

    Intracranial facial nerve schwannomas: current management and review of the literature.

    • Feng Xu, Sida Pan, Fernando Alonso, Simone E Dekker, and Nicholas C Bambakidis.
    • Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China.
    • World Neurosurg. 2017 Apr 1; 100: 444-449.

    BackgroundFacial nerve schwannomas are rare, benign, nerve-sheath tumors. They can occur in any segment of the facial nerve and often clinically and radiographically mimic the common vestibular schwannoma when extending into the cerebellopontine angle. The optimal treatment strategy for intracranial facial nerve schwannomas remains controversial.MethodsWe review the literature and discuss the natural history, clinical features, diagnosis and current management of facial nerve schwannoma.ResultsComplete tumor resection with facial nerve preservation can be achieved in fewer cases. In most cases, the affected segment of facial nerve must be removed if the goal is to achieve complete tumor section. Regardless of type of facial nerve repair, patients can expect no better than an eventual HB grade III palsy. Stereotactic radiosurgery has good results in tumor control and facial function outcome.ConclusionsTreatment for intracranial facial nerve schwannomas depends on clinical presentation, tumor size, preoperative facial, and hearing function. Conservative management is recommended for asymptomatic patients with small tumors. Stereotactic radiosurgery may be an option for smaller and symptomatic tumors with good facial function. If tumor is large or the patient has facial paralysis, surgical resection should be indicated. If preservation of the facial nerve is not possible, total resection with nerve grafting should be performed for those patients with facial paralysis, whereas subtotal resection is best for those patients with good facial function.Copyright © 2016. Published by Elsevier Inc.

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