Facial nerve schwannoma: Surgical excision versus conservative management

Facial nerve schwannomas are slow-growing tumors that may involve any part of the facial nerve. When they present with moderate to total facial palsy, complete resection is clearly indicated. However, in cases with mild or no facial dysfunction, the best course of treatment is less obvious. A series of 22 patients with facial nerve schwannoma is presented. of whom 12 under went definitive excision and 10 were managed more conservatively. The best postoperative facial function in the group who had tumor removal was a Hous e-Brackmann grade III, while 8 of the conservatively treated group had norm al facial function up to 10 years after presentation. As well. no significa nt tumor growth was noted on serial radiologic imaging of those being obser ved. Delaying surgical resection of facial nerve schwannomas may allow pati ents to retain normal facial function indefinitely.