Intraparotid facial nerve schwannoma: management decision based on facial nerve function. The Mayo Clinic Experience

2011 ◽  
Vol 121 (S5) ◽  
pp. S279-S279 ◽  
Author(s):  
Brian C Gross ◽  
Kerry D. Olsen ◽  
Eric J. Moore
Keyword(s):  
Facial Nerve ◽  
Mayo Clinic ◽  
Management Decision ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Clinic Experience ◽  
Facial Nerve Schwannoma

scholarly journals Facial Nerve Meningioma: A Case Mimicking Facial Nerve Schwannoma

2020 ◽  
pp. 014556132096258
Author(s):  
Wei Gao ◽  
Dingjing Zi ◽  
Lianjun Lu
Keyword(s):  
Facial Nerve ◽  
Internal Auditory Canal ◽  
Growth Patterns ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Reconstruction ◽  
Radiological Features ◽  
Facial Nerve Reconstruction ◽  
Facial Nerve Schwannoma ◽  
Grade Iii

Facial nerve meningioma is exceedingly rare and tends to affect the geniculate ganglion. We present a case of facial nerve meningioma located in the internal auditory canal with a “labyrinthine tail,” mimicking facial nerve schwannoma. The clinical and radiological features, growth patterns, and surgical management were reviewed. Progressive facial paralysis was the main syndrome, similar to other facial nerve tumors. When facial nerve function is worse than House-Brackmann grade III, surgical resection should be performed with facial nerve reconstruction.

scholarly journals Surgery versus radiosurgery for facial nerve schwannoma: a systematic review and meta-analysis of facial nerve function, postoperative complications, and progression

2020 ◽  
pp. 1-12
Author(s):  
Juliana Rotter ◽  
Victor M. Lu ◽  
Christopher S. Graffeo ◽  
Avital Perry ◽  
Colin L. W. Driscoll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Facial Nerve ◽  
Meta Analysis ◽  
Management Strategies ◽  
Complication Rates ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Operative Outcomes ◽  
Facial Nerve Schwannoma

OBJECTIVEIntracranial facial nerve schwannomas (FNS) requiring treatment are frequently recommended for surgery or stereotactic radiosurgery (SRS). The objective of this study was to compare facial nerve function outcomes between these two interventions for FNS via a systematic review and meta-analysis.METHODSA search of the Ovid EMBASE, PubMed, SCOPUS, and Cochrane databases from inception to July 2019 was conducted following PRISMA guidelines. Articles were screened against prespecified criteria. Facial nerve outcomes were classified as improved, stabilized, or worsened by last follow-up. Incidence was pooled by random-effects meta-analysis of proportions.RESULTSThirty-three articles with a pooled cohort of 519 patients with FNS satisfied all criteria. Twenty-five articles described operative outcomes in 407 (78%) patients; 10 articles reported SRS outcomes in 112 (22%). In the surgical cohort, facial nerve function improved in 23% (95% CI 15%–32%), stabilized in 41% (95% CI 32%–50%), and worsened in 30% (95% CI 21%–40%). In the SRS cohort, facial nerve function was improved in 20% (95% CI 9%–34%), stable in 66% (95% CI 54%–78%), and worsened in 9% (95% CI 3%–16%). Compared with SRS, microsurgery was associated with a significantly lower incidence of stable facial nerve function (p < 0.01) and a significantly higher incidence of worsened facial nerve function (p < 0.01). Tumor progression and complication rates were comparable. Outcome certainty assessments were very low to moderate for all parameters.CONCLUSIONSUnfavorable facial nerve function outcomes are associated with surgical treatment of intracranial FNS, whereas stable facial nerve function outcomes are associated with SRS. Therefore, SRS should be recommended to patients with FNS who require treatment, and surgery should be reserved for patients with another indication, such as decompression of the brainstem. Further study is required to definitively optimize and validate management strategies for these rare skull base tumors.

Surgery versus Radiosurgery for Facial Nerve Schwannoma: Systematic Review and Meta-analysis of Facial Nerve Function

2020 ◽  
Author(s):  
Juliana Rotter ◽  
Victor M. Lu ◽  
Avital Perry ◽  
Christopher S. Graffeo ◽  
Matthew L. Carlson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Facial Nerve ◽  
Meta Analysis ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Nerve Schwannoma

scholarly journals An Alternative Treatment for Facial Nerve Tumors: Short-Term Results of Radiotherapy

2008 ◽  
Vol 87 (10) ◽  
pp. 574-577 ◽  
Author(s):  
Todd A. Hillman ◽  
Douglas A. Chen ◽  
Russell Fuhrer
Keyword(s):  
Facial Nerve ◽  
Medical Records ◽  
The Other ◽  
Tumor Control ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Short Term ◽  
Hearing Results ◽  
Facial Nerve Schwannoma ◽  
Facial Function

A review of medical records of patients undergoing radiotherapy for facial nerve tumors was undertaken to determine subsequent facial nerve results, hearing results, and tumor control. Two patients with facial nerve tumors received this treatment. Facial nerve function remains excellent in one patient and significantly improved in the other. Neither tumor demonstrated growth. Current philosophies of facial nerve schwannoma management attempt to balance tumor control with facial nerve function. Radiotherapy for these tumors appears to preserve short-term facial function and may be a viable alternative to surgical management.

scholarly journals Gamma Knife surgery for facial nerve schwannomas

2014 ◽  
Vol 121 (Suppl_2) ◽  
pp. 116-122 ◽  
Author(s):  
Ju Hyung Moon ◽  
Won Seok Chang ◽  
Hyun Ho Jung ◽  
Kyu Sung Lee ◽  
Yong Gou Park ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Gamma Knife ◽  
Functional Outcomes ◽  
Gamma Knife Surgery ◽  
Tumor Control ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
The Mean ◽  
Clinical Records ◽  
Facial Nerve Schwannoma

ObjectThe aim of this study was to evaluate the tumor control rate and functional outcomes after Gamma Knife surgery (GKS) among patients with a facial nerve schwannoma.MethodsThe authors reviewed the radiological data and clinical records for 14 patients who had consecutively undergone GKS for a facial nerve schwannoma. Before GKS, 12 patients had facial palsy, 7 patients had hearing disturbance, and 5 patients had undergone partial or subtotal tumor resection. The mean and median tumor volumes were 3707 mm3 and 3000 mm3, respectively (range 117–10,100 mm3). The mean tumor margin dose was 13.2 Gy (range 12–15 Gy), and the mean maximum tumor dose was 26.4 Gy (range 24–30 Gy). The mean follow-up period was 80.7 months (range 2–170 months).ResultsControl of tumor growth was achieved in all 12 (100%) patients who were followed up for longer than 2 years. After GKS, facial nerve function improved in 2 patients, remained unchanged in 9 patients, and worsened in 3 patients. All patients who had had serviceable hearing at the preliminary examination maintained their hearing at a useful level after GKS. Other than mild tinnitus reported by 3 patients, no other major complications developed.ConclusionsGKS for facial nerve schwannomas resulted in excellent tumor control rates and functional outcomes. GKS might be a good primary treatment option for patients with a small- to medium-sized facial nerve schwannoma when facial nerve function and hearing are relatively preserved.

Intraoperative facial motor evoked potential monitoring for pontine cavernous malformation resection

2020 ◽  
Vol 132 (1) ◽  
pp. 265-271
Author(s):  
Ridzky Firmansyah Hardian ◽  
Tetsuya Goto ◽  
Yu Fujii ◽  
Kohei Kanaya ◽  
Tetsuyoshi Horiuchi ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Cavernous Malformation ◽  
Motor Evoked Potentials ◽  
Motor Evoked Potential ◽  
Warning Signs ◽  
Constant Current ◽  
Karnofsky Performance Scale ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Cavernous Malformations

OBJECTIVEThe aim of this study was to predict postoperative facial nerve function during pontine cavernous malformation surgery by monitoring facial motor evoked potentials (FMEPs).METHODSFrom 2008 to 2017, 10 patients with pontine cavernous malformations underwent total resection via the trans–fourth ventricle floor approach with FMEP monitoring. House-Brackmann grades and Karnofsky Performance Scale (KPS) scores were obtained pre- and postoperatively. The surgeries were performed using one of 2 safe entry zones into the brainstem: the suprafacial triangle and infrafacial triangle approaches. Six patients underwent the suprafacial triangle approach, and 4 patients underwent the infrafacial triangle approach. A cranial peg screw electrode was used to deliver electrical stimulation for FMEP by a train of 4 or 5 pulse anodal constant current stimulation. FMEP was recorded from needle electrodes on the ipsilateral facial muscles and monitored throughout surgery by using a threshold-level stimulation method.RESULTSFMEPs were recorded and analyzed in 8 patients; they were not recorded in 2 patients who had severe preoperative facial palsy and underwent an infrafacial triangle approach. Warning signs appeared in all patients who underwent the suprafacial triangle approach. However, after temporarily stopping the procedures, FMEP findings during surgery showed recovery of the thresholds. FMEPs in patients who underwent the infrafacial triangle approach were stable during the surgery. House-Brackmann grades were unchanged postoperatively in all patients. Postoperative KPS scores improved in 3 patients, decreased in 1, and remained the same in 6 patients.CONCLUSIONSFMEPs can be used to monitor facial nerve function during surgery for pontine cavernous malformations, especially when the suprafacial triangle approach is performed.

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