[Intracranial facial nerve schwannomas. Seven cases reviewed].
OBJECTIVE
Intracranial facial nerve schwannomas are rare neoplasms. Preoperative diagnosis is difficult because of non-specific clinical presentations (deafness, facial paralysis sudden or progressive) and radiological differential diagnosis (petrous bone tumor, vestibular schwannoma). Treatment depends on localization and has to be discussed for each case.


METHODS
Seven cases (four men and three women) of intracranial facial nerve schwannomas were retrospectively studied.


RESULTS
Before treatment, we found deafness in six cases (two sudden and four progressive), a facial palsy in five cases (three sudden and two progressive). Five patients had deafness and facial palsy. One patient had only headache. Three schwannomas were supra and intra-petrous, two in the cerebello-pontine angle, and two were plurifocal (petrous bone, internal auditive canal and cerebellopontine angle). Six patients were operated on with an oto-neurosurgical procedure. After treatment, facial palsy always worsened (requesting secondary hypoglosso-facial anastomosis in cinq cases). Only one case of transmission deafness improved after ossiculoplasty. One patient is still under clinical and radiological observation.


CONCLUSIONS
Diagnosis is difficult and made operatively in half of patients. A large tumor requires surgery, but surveillance can be a good option for a small one, considering the risk of postoperative facial palsy.
Fichten
A
A
Clinique de Neurochirurgie, Hôpital Roger-Salengro, CHRU, 59037 Lille Cedex, France. afichten@voila.fr
Bourgeois
P
P
Desaulty
A
A
Louis
E
E
Lejeune
J-P
JP
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003638:Deafness / Q000209:etiology / Q000601:surgery; D007758:Ear, Inner / Q000473:pathology / Q000601:surgery; D005155:Facial Nerve Diseases / Q000175:diagnosis / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D009460:Neurologic Examination; D010579:Petrous Bone / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies