Long-term outcomes of facial nerve schwannomas with favorable facial nerve function: tumor growth rate is correlated with initial tumor size

Yang, Wenchao; Zhao, Jing; Han, Yanyan; Yang, Huilin; Jun-ling, Xing; Zhang, Yongsen; Wang, Yufeng; Liu, Hui

doi:10.1016/j.amjoto.2014.10.019

Cited by 21 publications

(10 citation statements)

References 20 publications

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“…A recent study revealed that the growth rate of the tumor may be associated with initial tumor size which should be kept in mind in the followup period of these patients. 15 Observation with periodic examination and imaging should be preferred until the FNF deteriorates to a worse HB grade level. In case of slow growth rate or progressive symptoms (to HB II-IV), SRS or surgical decompression can be discussed.…”

Section: Discussionmentioning

confidence: 99%

Management of Facial Nerve Schwannoma: A Multicenter Study of 50 Cases

et al. 2018

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Objective In the management of facial nerve schwannoma (FNS), surgical tumor resection is now often being replaced with more conservative approaches, such as observation with serial imaging or stereotactic radiosurgery (SRS). Given the scarcity of these lesions, determining the optimal management of FNS remains challenging and subject of debate with multiple treatment approaches supported in the literature. Methods A retrospective chart review was performed in two academic centers for patients diagnosed with FNS between 1996 and 2017. The clinical presentation, treatment modalities employed, tumor control rates, and facial nerve function (FNF) outcomes (House–Brackmann system) were assessed and analyzed. Results The study comprised 50 adult patients. Initial treatment modalities included observation with serial clinicoradiologic review in 27 patients (54%), surgery in 17 patients (34%), and SRS in 6 patients (12%). The FNF were decreased in more than half of the patients who had surgery. Nonetheless, more than 80% of the patients who were initially managed with observation or SRS had stable or improved FNF. Conclusion A prevailing trend toward more conservative treatment modalities for FNS has evolved over time, providing relatively long-term preservation of FNF. As there are multiple management options available, it is of paramount importance that the treating physician be familiar with all treatment modalities and outcomes and counsel patients appropriately. The surgery should be reserved for large tumors and poor FNF at initial presentation or follow-up while watchful observation with imaging is the treatment of choice for rest of the patients.

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Section: Discussionmentioning

confidence: 99%

Management of Facial Nerve Schwannoma: A Multicenter Study of 50 Cases

et al. 2018

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“…Growth rate of the tumors in the larger size group was 72.7%, much higher than 10% for the smaller size. 11 Tumor growth rate is correlated with the tumor size, and wait-and-see scanning is not an alternative approach for large tumors even in patients with favorable facial nerve function.…”

Section: Discussionmentioning

confidence: 99%

Large Intratemporal Facial Nerve Schwannoma without Facial Palsy: Surgical Strategy of Tumor Removal and Functional Reconstruction

Yetışer

2018

J Neurol Surg A Cent Eur Neurosurg

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Conservative treatment with sparing of the nerve is considered in patients with small tumors. Excision of a large facial schwannoma with immediate hypoglossal nerve grafting as a primary procedure can provide satisfactory facial nerve function. One of the disadvantages of performing anastomosis is that there is not enough neural tissue just before the bifurcation of the main stump to provide neural suturing without tension because middle fossa extension of the facial schwannoma frequently involves the main facial nerve at the stylomastoid foramen. Reanimation should be processed with extensive backward mobilization of the hypoglossal nerve.

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“…This paradigm has changed, most likely with the advent of stereotactic radiosurgery. These are slow-growing tumours with a growth rate of approximately 0.4-2 mm per year [50,87]. Incidental small tumours without facial palsy can be safely monitored with clinical and radiological surveillance.…”

Section: Surgerymentioning

confidence: 99%

Management of non-vestibular schwannomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section Part II: Trigeminal and facial nerve schwannomas (CN V, VII)

et al. 2022

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Background Non-vestibular schwannomas are relatively rare, with trigeminal and jugular foramen schwannomas being the most common. This is a heterogenous group which requires detailed investigation and careful consideration to management strategy. The optimal management for these tumours remains unclear and there are several controversies. The aim of this paper is to provide insight into the main principles defining management and surgical strategy, in order to formulate a series of recommendations. Methods A task force was created by the EANS skull base section committee along with its members and other renowned experts in the field to generate recommendations for the surgical management of these tumours on a European perspective. To achieve this, the task force performed an extensive systematic review in this field and had discussions within the group. This article is the second of a three-part series describing non-vestibular schwannomas (V, VII). Results A summary of literature evidence was proposed after discussion within the EANS skull base section. The constituted task force dealt with the practice patterns that exist with respect to pre-operative radiological investigations, ophthalmological assessments, optimal surgical and radiotherapy strategies, and follow-up management. Conclusion This article represents the consensually derived opinion of the task force with respect to the treatment of trigeminal and facial schwannoma. The aim of treatment is maximal safe resection with preservation of function. Careful thought is required to select the appropriate surgical approach. Most middle fossa trigeminal schwannoma tumours can be safely accessed by a subtemporal extradural middle fossa approach. The treatment of facial nerve schwannoma remains controversial.

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Long-term outcomes of facial nerve schwannomas with favorable facial nerve function: tumor growth rate is correlated with initial tumor size

Cited by 21 publications

References 20 publications

Management of Facial Nerve Schwannoma: A Multicenter Study of 50 Cases

Management of Facial Nerve Schwannoma: A Multicenter Study of 50 Cases

Large Intratemporal Facial Nerve Schwannoma without Facial Palsy: Surgical Strategy of Tumor Removal and Functional Reconstruction

Management of non-vestibular schwannomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section Part II: Trigeminal and facial nerve schwannomas (CN V, VII)

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