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The presence of bilateral acoustic neuroma may require modification of the usual therapeutic protocol. Preservation of hearing and total removal of the tumour is much more difficult than in sporadic unilateral lesion. This case illustrates the management of a girl with bilateral acoustic neuroma with underlying neurofibromatosis type 2. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12609 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

Introduction: Facial nerve schwannoma is a rare benign tumour involving any site of the facial nerve where schwann cells are present. Case report: A 29-year-old lady presented with right ear tinnitus for one year, associated with reduced hearing for the last six months. Otherwise no other cranial nerves were involved. Patient did not complaint of any facial twitching or vestibular symptom. Patient was then investigated using audiological assessment and imaging which concluded the diagnosis as facial nerve schwannoma. In view of normal facial never function, the patient received conservative management. Discussion: Symptoms may differ according to the location of the tumour and also compression on the adjacent structures, namely facial nerve palsy, hearing loss and tinnitus. Treatment option depends on the grade of facial nerve palsy and its prognosis post-surgery. Although the mainstay of treatment is surgical excision, every patient has to be individually assessed and treated accordingly. Conclusion: Facial nerve schwannoma commonly presents with facial nerve palsy, however, a normal facial nerve does not exclude a facial nerve schwannoma. Therefore, imaging such as HRCT of temporal bone and MRI of internal auditory meatus needs to be done to reach an early diagnosis thus preventing complications.

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