title: Surgical management of internal auditory canal and cerebellopontine angle facial nerve schwannoma.
abstract: OBJECTIVE
  To investigate the long-term patient outcomes after tumor debulking for internal auditory canal facial schwannoma (FNS).
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Patients operated on between 1998 and 2010 for a preoperative diagnosis of vestibular schwannoma with the intraoperative identification FNS instead.
  
  
  METHODS
  Diagnostic and therapeutic.
  
  
  METHODS
  House-Brackmann facial nerve score immediately and at long-term follow-up (>1 yr); recurrence of tumor.
  
  
  RESULTS
  Sixteen patients were identified who were presumed to have vestibular schwannoma but intraoperatively were diagnosed with facial nerve schwannoma. Eleven underwent debulking surgery (67%-99% tumor removal), 2 underwent decompression only, 2 were diagnosed with nervus intermedius tumors and had total tumor removal with preservation of the motor branch of cranial nerve VII, and 1 had complete tumor removal with facial nerve grafting. Five of 11 debulking patients underwent the middle cranial fossa approach for tumor removal; the remainder had translabyrinthine resections. One debulking patient was lost to follow-up. Nine of 10 patients with long-term follow-up had House-Brackmann Grade I or II facial function. One patient had recurrence of the tumor that required revision surgery with total removal and facial nerve grafting.
  
  
  CONCLUSIONS
  Tumor debulking for FNS provides an opportunity for tumor removal and excellent facial nerve function. Continuous facial nerve monitoring is vital for successful debulking surgery. FNS debulking is feasible via the middle cranial fossa approach. Serial postoperative imaging is warranted to monitor for recurrence.
authors: Department of Otolaryngology, University of Iowa, Iowa 52249, USA. Sarah-mowry@uiowa.edu
authors: Sarah
authors: S
authors: Mowry
authors: Marlan
authors: M
authors: Hansen
authors: Bruce
authors: B
authors: Gantz
mesh_terms: D000328:Adult; D002530:Cerebellopontine Angle / Q000601:surgery*; D003390:Cranial Nerve Neoplasms / Q000601:surgery*; D019299:Decompression, Surgical; D004424:Ear Canal / Q000601:surgery*; D007758:Ear, Inner / Q000601:surgery; D005155:Facial Nerve Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009464:Neuroma, Acoustic / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies