title: A rare case of greater petrosal nerve schwannoma.
abstract: BACKGROUND
  Facial nerve schwannomas include only 0.8% of all intrapetrous mass lesions, and schwannomas originating exclusively from the greater petrosal nerve (GPN) are extremely rare. To date, only 13 reports have been described. In this case, the tumor was thought to originate from the GPN on the basis of clinical, radiological, and operative findings.
  
  
  METHODS
  A 23-year-old girl presented an acute left facial palsy, a disturbance in tear secretion of the ipsilateral eye, and a left-sided conductive hypoacusia. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an extradural mass in the left middle fossa. A subtemporal approach was performed and the lesion, originating from the proximal portion of the GPN, was excised. The post-operative course was satisfactory, except for a xerophtalmia, which was treated with artificial teardrops.
  
  
  CONCLUSIONS
  GPN schwannomas can originate anywhere alongside the course of the nerve, from its proximal segment near the facial hiatus to its distal segment near the foramen lacerum. For these reasons, it requires differential diagnosis with trigeminal nerve schwannomas or with injuries arising from the geniculate ganglion, because it can be easily confused with those lesions. However, in less severe cases, an early diagnosis can be able to preserve the function of the facial nerve by reducing iatrogenic injuries caused by surgical maneuvers.
authors.affiliation: Department of Neurosurgery, Second University of Naples, viale Colli Aminei 21, Naples, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: De Paulis
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Cola
authors.forename: Sara
authors.initials: S
authors.lastname: Marzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ricci
authors.forename: Gino
authors.initials: G
authors.lastname: Coletti
authors.forename: Renato J
authors.initials: RJ
authors.lastname: Galzio