title: Facial nerve schwannoma arising from the cerebellopontine angle.
abstract: A 74-year-old female suffered hearing disturbance in the right ear persisting for several years, followed by sudden onset of right facial nerve palsy. Her symptoms gradually worsened and neuroradiological imaging revealed a 4-cm cerebellopontine angle (CPA) tumor. Intraoperatively, the tumor was found to originate from the facial nerve. Total removal of the tumor was achieved, followed by a split hypoglossal-facial nerve anastomosis. Facial nerve schwannomas are rare and extremely difficult to preoperatively distinguish from vestibular schwannomas, especially if arising from the CPA and the internal auditory canal. However, preoperative diagnosis of facial nerve schwannomas is important because functional preservation of the facial nerve is more challenging than for vestibular schwannomas. Facial nerve palsy is one of the most unique symptoms in patients with facial nerve schwannomas, but is rare with vestibular schwannomas. Facial nerve schwannomas should be included in the differential diagnosis of CPA tumors with atypical clinical manifestations, and patients should be informed before surgery of the possibility of facial nerve dysfunction and the consequent need for facial nerve graft or reconstruction.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka 812-8582, Japan. amano@ns.med.kyushu-u.ac.jp
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Amano
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Sangatsuda
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hata
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inoue
authors.forename: Megumu
authors.initials: M
authors.lastname: Mori
authors.forename: Akira
authors.initials: A
authors.lastname: Nakamizo
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizoguchi
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000368:Aged; D002530:Cerebellopontine Angle / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D005154:Facial Nerve / Q000601:surgery; D005155:Facial Nerve Diseases / Q000175:diagnosis* / Q000601:surgery*; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D016067:Nerve Transfer; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed