Long Term Changes of Facial Nerve Schwannoma

Facial nerve schwannoma is a benign tumor which can emerge at any point along the facial nerve's course. It is characterized by its slow growth and a wide spectrum of symptoms, ranging from asymptomatic cases to involvement of lower cranial nerves. Despite its relative rarity, it presents substantial diagnostic and therapeutic challenges. Traditionally, surgical excision dominated its management. Nevertheless, with advancements in imaging and radiation therapy, alternative strategies, like watchful observation and radiation therapy, have gained prominence. In this study, we present findings from three facial nerve schwannoma cases. Two cases exhibited no facial nerve palsy, with the tumors showing no growth over observation periods of 7 years and 6 years, respectively. In contrast, a patient with House-Brackmann (H-B) grade IV facial nerve palsy underwent surgical resection. Encouragingly, the tumor did not recur over and 11-year follow-up and the patient's facial palsy improved to H-B grade III. These cases provide valuable insights guiding future treatment approaches for facial nerve schwannoma.