Facial Nerve Schwannomas

Review of 80 Cases Over 25 Years at Mayo Clinic

Matthew L. Carlson, Nicholas L. Deep, Neil S. Patel, Larry B Lundy, Nicole M. Tombers, Christine M. Lohse, Michael J. Link, Colin L. Driscoll

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective To elucidate the long-term clinical behavior, treatment, and outcomes of sporadic facial nerve schwannoma (FNS) in a large cohort of patients managed in the post–magnetic resonance imaging era. Patients and Methods Retrospective review at a single tertiary health care system (January 1, 1990, through December 31, 2015), evaluating 80 consecutive patients with sporadic FNS. Results Ninety-eight patients with FNS were identified; 10 with incomplete data and 8 with neurofibromatosis type 2 were excluded. The remaining 80 patients (median age, 47 years; 58% women) were analyzed. Forty-three (54%) patients presented with asymmetrical hearing loss, 33 (41%) reported facial paresis, and 21 (26%) reported facial spasm. Seventeen (21%) exhibited radiologic features mimicking vestibular schwannoma, 14 (18%) presented as a parotid mass, and 5 (6%) were discovered incidentally. Factors predictive of facial nerve paresis or spasm before treatment were female sex and tumor involvement of the labyrinthine/geniculate and tympanic facial nerve segments. The median growth rate among growing FNS was 2.0 mm/y. Details regarding clinical outcome according to treatment modality are described. Conclusion In patients with FNS, female sex and involvement of the labyrinthine/geniculate and tympanic segments of the facial nerve predict a higher probability of facial paresis or spasm. When isolated to the posterior fossa or parotid gland, establishing a preoperative diagnosis of FNS is challenging. Treatment should be tailored according to tumor location and size, existing facial nerve function, patient priorities, and age. A management algorithm is presented, prioritizing long-term facial nerve function.

Original languageEnglish (US)
Pages (from-to)1563-1576
Number of pages14
JournalMayo Clinic Proceedings
Volume91
Issue number11
DOIs
StatePublished - Nov 1 2016

Fingerprint

Neurilemmoma
Facial Nerve
Facial Paralysis
Spasm
Neurofibromatosis 2
Acoustic Neuroma
Parotid Gland
Tertiary Healthcare
Hearing Loss
Neoplasms
Therapeutics
Delivery of Health Care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Carlson, M. L., Deep, N. L., Patel, N. S., Lundy, L. B., Tombers, N. M., Lohse, C. M., ... Driscoll, C. L. (2016). Facial Nerve Schwannomas: Review of 80 Cases Over 25 Years at Mayo Clinic. Mayo Clinic Proceedings, 91(11), 1563-1576. https://doi.org/10.1016/j.mayocp.2016.07.007

Facial Nerve Schwannomas : Review of 80 Cases Over 25 Years at Mayo Clinic. / Carlson, Matthew L.; Deep, Nicholas L.; Patel, Neil S.; Lundy, Larry B; Tombers, Nicole M.; Lohse, Christine M.; Link, Michael J.; Driscoll, Colin L.

In: Mayo Clinic Proceedings, Vol. 91, No. 11, 01.11.2016, p. 1563-1576.

Research output: Contribution to journalArticle

Carlson, ML, Deep, NL, Patel, NS, Lundy, LB, Tombers, NM, Lohse, CM, Link, MJ & Driscoll, CL 2016, 'Facial Nerve Schwannomas: Review of 80 Cases Over 25 Years at Mayo Clinic', Mayo Clinic Proceedings, vol. 91, no. 11, pp. 1563-1576. https://doi.org/10.1016/j.mayocp.2016.07.007
Carlson, Matthew L. ; Deep, Nicholas L. ; Patel, Neil S. ; Lundy, Larry B ; Tombers, Nicole M. ; Lohse, Christine M. ; Link, Michael J. ; Driscoll, Colin L. / Facial Nerve Schwannomas : Review of 80 Cases Over 25 Years at Mayo Clinic. In: Mayo Clinic Proceedings. 2016 ; Vol. 91, No. 11. pp. 1563-1576.
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