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

19 Scopus citations


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
Issue number11
StatePublished - Nov 1 2016


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., Link, M. J., & 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