title: [Diagnosis and treatment of facial nerve schwannoma in patients with normal facial nerve function or slight facial palsy].
abstract: OBJECTIVE
  To investigate the diagnosis and treatment of facial nerve schwannomas with facial nerve function House-Brackmann grade (HB) ≤ grade II.
  
  
  METHODS
  A retrospective study was conducted in Peking Union Medical College Hospital. We reviewed eight cases of facial nerve schwannomas with facial nerve function HB ≤ grade II, which were diagnosed and managed between Jan 1996 and March 2011.
  
  
  RESULTS
  The initial presenting symptoms of the eight patients were not facial paralysis. Eight patients were misdiagnosed and six had mistreatment histry. CT and(or) MRI results in all patients showed that the tumors originated from different part of the facial nerves. All patients received operation. Facial nerves were completely preserved in four patients because of easy separation of the tumors from the facial nerves in surgery, facial function was gradeII-III over 17 - 180 months' follow-up. The tumors were attached with the facial nerves in two patients with wide extension involving cochlea and labyrinth, therefore the tumors were removed together with the attached facial nerves, and the nerves were repaired by using the greater auricular nerves. Facial function was grade VI over 56 - 79 months' follow-up. One patient refused to sacrifice the facial nerve, wide decompression of facial nerve and tumor was undertaken, facial function was grade III over 8 months' follow-up. One chorda tympani neuroma was removed with the branch of the facial nerve, facial function was grade II over 8 months' follow-up.
  
  
  CONCLUSIONS
  The facial nerve schwannomas with facial nerve function HB ≤ grade II is difficult to diagnosis. The therapy strategy should depend on the patients' choice, position of the tumor and adherences of the tumor to facial nerve. Facial nerve could be preserved if the tumor is easy to be separated from the facial nerve during operation, if not, total remove the tumor and nerve repairment are indicted when invasion into the inner ear canal, cerebro pontine angle, cochlea or labyrinth. If patients refuse to sacrifice the facial nerve, facial nerve decompression and periodic follow-up are recommended.
authors.affiliation: Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Zhi-qiang
authors.initials: ZQ
authors.lastname: Gao
authors.forename: Hong
authors.initials: H
authors.lastname: Jiang
authors.forename: Xing-ming
authors.initials: XM
authors.lastname: Chen
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Wu
authors.forename: Guo-dong
authors.initials: GD
authors.lastname: Feng
authors.forename: Yang
authors.initials: Y
authors.lastname: Zha
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D005154:Facial Nerve / Q000473:pathology; D005158:Facial Paralysis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult