Skip to main content
SpringerLink
Log in

Intraparotid facial nerve schwannoma: management options

  • Miscellaneous
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Intraparotid facial nerve schwannoma (FNS) is a very rare, benign tumour mimicking pleomorphic adenoma. Resection of this slow growing tumour may result in unnecessary facial nerve paralysis. The aim of this study is to present results of facial nerve schwannoma treatment at our institution and proposes a management plan. This is a retrospective case series of four patients, three male and one female with a mean age of 47.7 years who presented with a long-standing, asymptomatic parotid swelling. Two patients had facial weakness and underwent superficial parotidectomy, resection of tumour and facial nerve repair with a free graft from the greater auricular nerve. Two patients underwent biopsy without tumour resection. All tumours were confirmed histologically as facial nerve schwannomas. The mean follow up period was 3.5 years. Patients with resection of facial nerve schwannoma had a postoperative House Brackmann grade III and IV. Patients with biopsy had normal postoperative facial nerve function and the tumour did not grow significantly. No adverse effects or recurrence were reported. There is no preoperative diagnostic modality that can identify facial nerve schwannoma with certainty. Difficulty in locating the facial nerve intraoperatively raises suspicion of a neurogenous tumour of the facial nerve and this may prevent unnecessary damage to the nerve. Not every facial nerve schwannoma should be resected. This decision is based on (a) the extent of tumour (b) preoperative facial nerve function (c) best results achieved with nerve repair and (d) patient’s preferences. Large tumours with extension into the mastoid cavity or encroachment of sensitive structures and preoperative facial weakness are indications for surgical intervention. In most other cases, biopsy and observation suffices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Sneige N, Batsakis JG (1991) Primary tumors of the facial (extracranial) nerve. Ann Otol Rhinol Laryngol 100(7):604–606

    PubMed  CAS  Google Scholar 

  2. Caughey RJ, May M, Schaitkin BM (2004). Intraparotid facial nerve schwannoma: diagnosis and management. Otolaryngol Head Neck Surg 130(5):586–592

    Article  PubMed  Google Scholar 

  3. Elahi MM, Audet N, Rochon L, Black MJ (1995) Intraparotid facial nerve schwannoma. J Otolaryngol 24(6):364–367

    PubMed  CAS  Google Scholar 

  4. Chung JW, Ahn JH, Kim JH, Nam SY, Kim CJ, Lee KS (2004) Facial nerve schwannomas: different manifestations and outcomes. Surg Neurol 62(3):245–252; discussion 452

    Article  PubMed  Google Scholar 

  5. Bretlau P, Melchiors H, Krogdahl A (1983) Intraparotid neurilemmoma. Acta Otolaryngol 95(3–4):382–384

    Article  PubMed  CAS  Google Scholar 

  6. Jaehne M, Ussmuller J (2001) Clinical aspects and therapy of extratemporal facial neurinoma. HNO 49(4):264–269

    Article  PubMed  CAS  Google Scholar 

  7. O’Donoghue GM, Brackmann DE, House JW, Jackler RK (1989) Neuromas of the facial nerve. Am J Otol 10(1):49–54

    PubMed  CAS  Google Scholar 

  8. Gritzmann N, Rettenbacher T, Hollerweger A, Macheiner P, Hubner E (2003) Sonography of the salivary glands. Eur Radiol 13(5):964–975

    PubMed  CAS  Google Scholar 

  9. Howlett DC, Kesse KW, Hughes DV, Sallomi DF (2002) The role of imaging in the evaluation of parotid disease. Clin Radiol 57(8):692–701

    Article  PubMed  CAS  Google Scholar 

  10. Jager L, Reiser M (2001) CT and MR imaging of the normal and pathologic conditions of the facial nerve. Eur J Radiol 40(2):133–146

    Article  PubMed  CAS  Google Scholar 

  11. Shimizu K, Iwai H, Ikeda K, Sakaida N, Sawada S (2005) Intraparotid facial nerve schwannoma: a report of five cases and an analysis of MR imaging results. AJNR Am J Neuroradiol 26(6):1328–1330

    PubMed  Google Scholar 

  12. Chiang CW, Chang YL, Lou PJ (2001) Multicentricity of intraparotid facial nerve schwannomas. Ann Otol Rhinol Laryngol 110(9):871–874

    PubMed  CAS  Google Scholar 

  13. Maly B, Maly A, Doviner V, Reinhartz T, Sherman Y (2003) Fine needle aspiration biopsy of intraparotid schwannoma. A case report. Acta Cytol 47(6):1131–1134

    PubMed  Google Scholar 

  14. Assad L, Treaba D, Ariga R, Bengana C, Kapur S, Bhattacharya B, Reddy VB, Gould VE, Gattuso P, Yana D (2004) Fine-needle aspiration of parotid gland schwannomas mimicking pleomorphic adenoma: a report of two cases. Diagn Cytopathol 30(1):39–40

    Article  PubMed  CAS  Google Scholar 

  15. Chong KW, Chung YF, Khoo ML, Lim DT, Hong GS, Soo KC (2000) Management of intraparotid facial nerve schwannomas. Aust N Z J Surg 70(10):732–734

    Article  PubMed  CAS  Google Scholar 

  16. Laurian N, Zohar Y (1970) Malignant neurilemmoma of parotid gland. J Laryngol Otol 84(12):1267–1271

    Article  PubMed  CAS  Google Scholar 

  17. McGuirt WF S, Johnson PE, McGuirt WT (2003) Intraparotid facial nerve neurofibromas. Laryngoscope 113(1):82–84

    Article  PubMed  Google Scholar 

  18. Angeli SI, Brackmann DE (1997) Is surgical excision of facial nerve schwannomas always indicated? Otolaryngol Head Neck Surg 117(6):S144–S147

    Article  PubMed  CAS  Google Scholar 

  19. Kreeft A, Schellekens PP, Leverstein H (2007) Intraparotid facial nerve schwannoma. What to do? Clin Otolaryngol 32(2):125–129

    Article  PubMed  CAS  Google Scholar 

  20. Marchioni D, Alicandri Ciufelli M, Presutti L (2007) Intraparotid facial nerve schwannoma: literature review and classification proposal. J Laryngol Otol 121(8):707–712

    Article  PubMed  CAS  Google Scholar 

  21. May M (2000) Nerve repair. In: May M, Schaitkin BM (eds) The facial nerve, May’s second edition, 2nd edn. Thieme, New York, pp 571–609

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Kiriakidi 1, 546 36, Thessaloniki, Greece

    G. Fyrmpas, I. Konstantinidis, D. Hatzibougias, V. Vital & J. Constantinidis

  2. Andrea Papandreou 96, 56728, Thessaloniki, Neapoli, Greece

    G. Fyrmpas

Authors
  1. G. Fyrmpas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Konstantinidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Hatzibougias
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Vital
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Constantinidis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Fyrmpas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fyrmpas, G., Konstantinidis, I., Hatzibougias, D. et al. Intraparotid facial nerve schwannoma: management options. Eur Arch Otorhinolaryngol 265, 699–703 (2008). https://doi.org/10.1007/s00405-007-0521-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-007-0521-8

Keywords

Search

Navigation