Neglected left intraparotid facial nerve schwannoma causing complete facial nerve palsy: A case report

Extracranial schwannomas in the head and neck region are relatively rare neoplasms. The tumours are slow growing and often unnoticeable. The nerve of origin is unable to be determined until the time of surgery. Proper preoperative assessment of the disease can be done by imaging studies such as magnetic resonance imaging. The treatment for these tumours is surgical resection with preservation of the neural pathway. We report a case of left intraparotid facial nerve schwannoma in a middle-aged lady causing complete facial nerve paralysis. The clinical features, diagnostic possibilities and management are discussedBangladesh Journal of Medical Science Vol.17(4) 2018 p.680-682

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Bilateral Facial Palsy in Rapidly Progressive Course of Wegener’s Granulomatosis: A Case Report

Case Reports in Otolaryngology ◽

10.1155/2013/875108 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Anna Roszkowska ◽

Monika Morawska-Kochman ◽

Hanna Temporale ◽

Małgorzata Sikorska-Żuk ◽

Tomasz Kręcicki

Keyword(s):

Facial Nerve ◽

Wegener’S Granulomatosis ◽

Systemic Vasculitis ◽

Neck Region ◽

Wegener's Granulomatosis ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Head And Neck Region ◽

Proper Diagnosis ◽

Surgical Treatments

Introduction. Wegener’s granulomatosis belongs to a group of systemic vasculitis diseases, which is characterized by necrotizing vasculitis and presence of granulomas. In a lot of cases, the first symptoms of the disease are observed in the head and neck region, but the bilateral facial nerve palsy occurs very rarely.Objective. The objective of our report was to describe the unusual course of Wegener’s granulomatosis with the bilateral facial nerve paralysis, which subsided after application of steroids and immunosuppressive therapy in combination with surgical treatment.Results and Conclusions. Hearing loss may precede other symptoms in Wegener’s granulomatosis. Ear pain and otorrhea may suggest the diagnosis of bacterial purulent otitis media and delay the proper diagnosis. In the presented case, considering the clinical course, it was necessary to apply both pharmacological and surgical treatments.

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Aetiological Profile of Facial Nerve Palsy Seen in Nigerian Tertiary Hospital

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i06/877 ◽

2020 ◽

Vol 5 (06) ◽

Author(s):

Gabriel Toye Olajide ◽

Waheed Atilade Adegbiji ◽

Akinwale Olaleye Akinbade ◽

Anthony Oyebanji Olajuyin ◽

Paul Olowoyo

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Road Traffic ◽

Neck Region ◽

Bell’S Palsy ◽

Facial Nerve Paralysis ◽

Bell's Palsy ◽

Female Ratio ◽

Nerve Paralysis

Background/Aim: Facial nerve palsy may cause facial asymmetry, functional and cosmetic impairment, and therefore imposes great psychological and social problems on the individual with the condition. The aim of this paper was to highlight the aetiological profile of facial nerve palsy (FNP) in two tertiary institutions in Ekiti, southwest, Nigeria. Methods: This was a retrospective review of patients with facial nerve palsy seen and treated at Ear, Nose & Throat (ENT) clinic. All folders and registers of patients diagnosed with facial nerve palsy from January 2010 to December 2019 in the central, ENT and Dental medical records departments were retrieved and reviewed. The information extracted included the socio-demographic characteristics of the patients, clinical presentation, type and aetiology of FNP, side affected, diagnosis/impression, nature of impairment, type of lesion, onset of the disease, treatment and outcome. Results: Of 76 patients analysed, 48(63.2%) were males and 28(36.8%) were females given a male to female ratio of 1:1.7. Their age ranged between 5 to 72 years with a mean of 39.83 ± 17.58 SD. The age range 21-40 years was most commonly affected, representing 31 (40.8%). The commonest cause of facial nerve paralysis was Bell’s palsy in 32(42.1%), followed by trauma 28(36.9%). Of the 28 (36.9%) that was caused by trauma, road traffic injury constituted 15(53.6%). Half (50.0 %) of the lesion affected right side of the face. Seventy (92.1%) was treated medically. Majority (37.0%) presented within one week of their symptoms. All the patients presented with deviation of mouth, followed by inability to close eye in 70 (92.1%). Higher proportion (88.2%) of our patients had lower motor neuron lesion. Conclusion: This study found that majority of our patients was young adults. Bell’s palsy was a major cause of facial nerve paralysis followed by trauma. Most of our patient presented early and did well on conservative treatment. High index of suspicion is essential especially when patients present with injuries involving head and neck region.

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Rare extracranial localizations of the head and neck schwannomas

Vojnosanitetski pregled ◽

10.2298/vsp1007596j ◽

2010 ◽

Vol 67 (7) ◽

pp. 596-599

Author(s):

Milan Jovanovic ◽

Ljiljana Cvorovic ◽

Rastislav Poljovka ◽

Aleksandar Oroz ◽

Ljubomir Pavicevic

Keyword(s):

Head And Neck ◽

Neck Region ◽

Soft Tissue Tumors ◽

Autonomic Nerves ◽

Head And Neck Region ◽

Delay In Diagnosis ◽

Benign Soft Tissue Tumors ◽

Indispensable Tool ◽

Slow Growing ◽

Nerve Of Origin

Introduction. Schwannomas are tumors of neurogenic origin, that arise from Schwann cells which surround peripheral, cranial and autonomic nerves. Schwannomas account for only 5% of all benign soft tissue tumors, and 25-45% of extracranial schwannomas are present in the head and neck region. They are usually classified according to the nerve of origin and the site within the head and neck. Case report. We presented extremely rare extracranial localizations of schwannomas and discussed about diagnosis and management of these tumors. Conclusion. Schwannomas are slow-growing tumors and late symptoms appearance may cause a delay in diagnosis and treatment of patients with these tumors. An appropriate diagnostic protocol is indispensable tool in performing a differential diagnosis of malignant from benign lesions. Choice of surgical approach depends on schwannomas localization.

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Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management

Case Reports in Otolaryngology ◽

10.1155/2016/3939685 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Murat Damar ◽

Aykut Erdem Dinç ◽

Sultan Şevik Eliçora ◽

Sultan Bişkin ◽

Gül Erten ◽

...

Keyword(s):

Parotid Gland ◽

Facial Nerve ◽

Benign Tumors ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Seventh Cranial Nerve ◽

Peripheral Facial Nerve Palsy ◽

Painless Mass ◽

Facial Nerve Schwannoma ◽

Left Parotid Gland

Facial nerve schwannomas (FNS) are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature.

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Facial nerve schwannoma: a rare case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164823 ◽

2016 ◽

Vol 3 (1) ◽

pp. 159

Author(s):

Suchina Parmar ◽

Jai Lal Davessar ◽

Gurbax Singh

Keyword(s):

Facial Nerve ◽

Schwann Cells ◽

Benign Tumor ◽

Facial Nerve Paralysis ◽

Vestibulocochlear Nerve ◽

Nerve Paralysis ◽

Delay In Diagnosis ◽

Rare Case Report ◽

Early Imaging ◽

Facial Nerve Schwannoma

<p class="abstract"><span lang="EN-IN">Schwannoma is a benign tumor arising from Schwann cells which is protective covering of nerves, called myelin sheath and can develop anywhere, where Schwann cells are present. Most common schwannomas are found with vestibulocochlear nerve. Facial nerve schwannoma are uncommon tumour involving 7th nerve out of which also most common site of involvement is geniculate ganglion. Facial nerve schwannoma is uncommon benign tumor. There are no typical patterns of presentation and can easily go untreated or misdiagnosed. Facial nerve palsy is most common mode of presentation. Here we present a case of 35 years male who presented with complaint of facial nerve paralysis. High degree of clinical suspicion and early imaging can lead to diagnosis. An early diagnosis is important as morbidity associated with this disease and as well as surgery leads to delay in diagnosis.</span></p>

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Intraparotid Facial Nerve Schwannoma with Temporal Bone Extension

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v27i1.549 ◽

2012 ◽

Vol 27 (1) ◽

pp. 23-27

Author(s):

Alexander T. Laoag ◽

Antonio H. Chua ◽

Thanh Vu T. De Guzman ◽

Samantha S. Castañeda ◽

Jose A. Malanyaon

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Facial Nerve ◽

Hypoglossal Nerve ◽

Tumor Resection ◽

Facial Nerve Paralysis ◽

Resonance Imaging ◽

Nerve Paralysis ◽

Nerve Tumor ◽

Facial Nerve Schwannoma

Objective: To present a rare case of facial schwannoma manifesting as a parotid mass and discuss its diagnosis and treatment.Methods: Design: Case Report Setting: Tertiary Government Hospital Patient: OneResults: A 48-year-old female was seen for a 2-year progressive left hemifacial paralysis and a 5-month gradually enlarging left infraauricular mass with episodes of tinnitus but intact hearing and balance. Physical examination showed a left-sided House Brackmann grade VI facial paralysis and a 5 x 4 x 3 cm soft, ill-defined, slightly movable, nontender, left infraauricular mass. Gadolinium-enhanced magnetic resonance imaging revealed a 5 cm heterogeneouslyenhancing lobulated mass centered within the deep lobe of the left parotid gland extending to the left mastoid, with facial nerve involvement. A diagnosis of a facial nerve tumor, probably a schwannoma, was entertained. Pure tone audiometry revealed normal hearing thresholds for both ears with dips at 6-8 KHz on the left. The patient underwent total parotidectomy withfacial nerve tumor resection via transmastoid approach, with simultaneous facial – hypoglossal nerve anastomosis reconstruction. Histopathologic findings confirmed the diagnosis of a schwannoma. Postoperative facial function was Grade VI. Hearing and hypoglossal nerve function were preserved.Conclusion: A progressive hemifacial paralysis of chronic duration with or without the presence of an infra-auricular mass should raise the suspicion of a facial nerve tumor. Gadolinium-enhanced magnetic resonance imaging is valuable since intraparotid facial nerve schwannomas are mostly diagnosed intraoperatively when the neoplasm and the nerve are exposed and determined to be contiguous. The clinician should be aware that not all parotid masses are salivary gland in origin.Keywords: intraparotid facial nerve schwannoma, facial nerve paralysis, parotid mass

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