耳鼻科ジャーナル

Facial Nerve Schwannomas: Presentation and Our Results of Treatment Comparing Three Techniques

Diplan Rubio J, Vales O, Palma D�az M, Vega Alarc�n A, Romero D, Morales del �ngel J, Hinojosa R

The facial nerve schwannoma (FNS) is a tumor originated from Schwann cells. It may appear in any part of the nerve, from its origin in the cerebellopontine angle to its extracranial branches in the parotid space.

Objectives: the present study aims to present different forms of presentation, evolution and management of facial schwannomas and compare the results of the three therapeutic modalities (observation, radiotherapy and surgery) used in our observation.

Material and methods: A retrospective review of all facial schwannomas cases in neuro-otology’ service at the National Institute of Neurology and neurosurgery Manuel Velasco Suárez from 2005 to 2014 have been considered for this study.

Results: 12 patients consisting 9 women and 3 men in the age group of 27-82 years, with an average age of 51.3 years were identified for this study. At the beginning all the cases have showed some degree of peripheral facial paralysis as per the House- Brackmann scale (HB). They are graded into three categories: 16.6% (2) cases in grade II and V; 25% (3) of cases as grade III and 5 and 41.6% (4) cases as grade VI. Three therapeutic modalities including observation with MRI studies in 3 cases (25%), radiotherapy in 4 (33.3%) cases and surgery in 5 (41.6%) cases have been adopted. The procedure consisting of microsurgical resection alone, microsurgical resection more nerve repair with sural nerve graft inginter position (SNI) or just terminal anastomosis of the facial nerve without nerve interposition.

Conclusions: The facial nerve schwannomas are manifested in different ways. Most patients with sudden and recent facial palsy recover from this disease after a systemic steroid use. The study concludes that the treatment should always be aimed to preserving the facial and auditory function.