Management of intratemporal facial nerve schwannoma.
OBJECTIVE
The aim of this study was to report a series of 18 facial nerve schwannomas, including 2 infantile cases.


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
Eighteen patients with facial nerve schwannoma, operated on between 1980 and 2000.


METHODS
Surgical treatments were performed in all cases.


METHODS
The presenting symptoms and facial nerve function were graded using the House-Brackmann scale and eye closure. RESULTS Facial nerve paralysis was the most common symptom, presenting in 94% of cases, followed by hearing loss and mass lesion. In one case, the tumor was shaved, leaving the facial nerve intact. In the other cases, the facial nerve reconstruction with hypoglossal-facial anastomosis or interposition graft was performed. The postoperative facial function was House-Brackmann grade IV in most cases (88.2%). In terms of the functional recovery classified by complete or incomplete eye closure, the moderate preoperative facial nerve palsy group showed a better functional outcome than severe group.


CONCLUSIONS
In cases with good facial nerve function, it would be better to consider an alternative method for preserving the facial nerve. Furthermore, when facial nerve paralysis has developed to more than House-Brackmann grade III, an immediate operation is recommended to obtain a good postoperative facial functional recovery.
Kim
Chong-Sun
CS
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea. chongkom@plaza.snu.ac.kr
Chang
Sun O
SO
Oh
Seung Ha
SH
Ahn
Soon-Hyun
SH
Hwang
Chan Ho
CH
Lee
Hyo Jeong
HJ
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005154:Facial Nerve / Q000473:pathology / Q000601:surgery*; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007002:Hypoglossal Nerve / Q000637:transplantation; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013703:Temporal Muscle