Intracranial Facial Nerve Schwannomas: Current Management and Review of Literature.
BACKGROUND
Facial nerve schwannomas are rare, benign, nerve-sheath tumors. They can occur in any segment of the facial nerve and often clinically and radiographically mimic the common vestibular schwannoma when extending into the cerebellopontine angle. The optimal treatment strategy for intracranial facial nerve schwannomas remains controversial.


METHODS
We review the literature and discuss the natural history, clinical features, diagnosis and current management of facial nerve schwannoma.


RESULTS
Complete tumor resection with facial nerve preservation can be achieved in fewer cases. In most cases, the affected segment of facial nerve must be removed if the goal is to achieve complete tumor section. Regardless of type of facial nerve repair, patients can expect no better than an eventual HB grade III palsy. Stereotactic radiosurgery has good results in tumor control and facial function outcome.


CONCLUSIONS
Treatment for intracranial facial nerve schwannomas depends on clinical presentation, tumor size, preoperative facial, and hearing function. Conservative management is recommended for asymptomatic patients with small tumors. Stereotactic radiosurgery may be an option for smaller and symptomatic tumors with good facial function. If tumor is large or the patient has facial paralysis, surgical resection should be indicated. If preservation of the facial nerve is not possible, total resection with nerve grafting should be performed for those patients with facial paralysis, whereas subtotal resection is best for those patients with good facial function.
Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China.
Feng
F
Xu
Department of Plastic Surgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China.
Sida
S
Pan
Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Fernando
F
Alonso
Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Simone E
SE
Dekker
Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA. Electronic address: Nicholas.Bambakidis2@UHhospitals.org.
Nicholas C
NC
Bambakidis
D019468:Disease Management; D005154:Facial Nerve / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D009442:Neurilemmoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000639:trends*; D016896:Treatment Outcome
Facial nerve schwannoma; Stereotactic radiosurgery; Surgery