Magnetic resonance imaging of facial nerve schwannoma

Thompson, Andrew; Aviv, Richard I.; Chen, Joseph M.; Nedzelski, Julian M.; Yuen, Heng-Wai; Fox, Allan J.; Bharatha, Aditya; Bartlett, Eric; Symons, Sean

doi:10.1002/lary.20644

Cited by 40 publications

(34 citation statements)

References 28 publications

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“…5,7,10) On the other hand, facial weakness is the most important and unique clinical symptom, found in 57% to 63% of patients with facial nerve schwannomas, but only 5% to 7% of patients with vestibular schwannomas, even large ones. 5,7,9) These findings strongly suggest that facial nerve palsy associated with CPA tumors might be indicative of facial nerve schwannomas. Another unique clinical symptom associated with facial nerve schwannomas is facial spasm, reported in 2% to 27% of patients, as compared with 0.6% of patients with vestibular schwannomas.…”

Section: Discussionmentioning

confidence: 78%

“…1) In addition to their rarity, CPA facial nerve schwannomas are often indistinguishable from vestibular schwannomas until operative intervention. 9) CPA tumors may manifest as various clinical symptoms. Hearing disturbance is the most common symptom in patients with CPA tumors, including facial nerve schwannomas.…”

Section: Discussionmentioning

confidence: 99%

“…Another unique clinical symptom associated with facial nerve schwannomas is facial spasm, reported in 2% to 27% of patients, as compared with 0.6% of patients with vestibular schwannomas. 4,7,9) We should carefully consider facial nerve schwannomas in the differential diagnosis of CPA tumors, especially in patients with atypical clinical manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…MR imaging with gadolinium can identify enhancement of the facial canal or the geniculate ganglion in the middle cranial fossa in cases of facial nerve schwannomas involving the geniculate ganglion. 2,[8][9][10] Without this distinction, this rare tumor is very difficult to preoperatively diagnose as facial nerve schwannoma, even with small tumors. We should carefully consider enhanced lesions in the middle cranial fossa when assessing CPA tumors with MR imaging, especially in cases with atypical clinical presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Other symptoms include tinnitus and ear canal pain. 3,7,9) Hearing disturbance is a common symptom with tumors such as vestibular schwannomas or CPA meningiomas. On the other hand, facial weakness is a rare symptom for such tumors, even if relatively large, and facial weakness is more commonly attributable to facial nerve schwannoma.…”

Section: Introductionmentioning

confidence: 99%

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Facial Nerve Schwannoma Arising From the Cerebellopontine Angle

Amano

Sangatsuda

Hata

et al. 2013

Neurol. Med. Chir.(Tokyo)

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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.

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