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A facial nerve schwannoma is a growth made of schwann cells which form part of the
insulating sheath around the nerve.
Facial nerve tumours are almost always benign, which means they are not cancerous; however
they can still cause problems.
Facial twitching
Recurring one-sided facial weakness which gets better and then returns.
Please note that some people may have very little, by way of symptoms, to report.
The patients history about the onset of their symptoms is most helpful in directing further
investigations.
The GP or doctor should observe for weakness of the facial muscles on one side of the
face.
Observations of the facial muscles should be made with the face at rest and during
movements including eye closure and blinking. It is useful to have medical photographs.
Hearing tests should be carried out if there is any suspicion that the diagnosis is a facial
nerve tumour, even when there is no reported hearing loss.
Physical examination of the face and neck to exclude the presence of any tumours that
may be easily felt or seen, especially salivary gland tumours.
Recurrent episodes of facial paralysis or weakness should alert the clinician to a possible
diagnosis of a facial nerve tumour.
As tumours can grow on any part of the facial nerve, all investigations should include the
whole length of the nerve rather than sections.
If the symptoms are very mild, then the clinician may suggest monitoring the facial nerve
regularly using MRI. Facial nerve tumours are often very slow-growing and may only
cause mild symptoms throughout a persons life.
If the patients facial weakness is more obvious, then surgical removal of the tumour is
usually recommended. It is often easier to preserve the facial nerve if the tumour has not
grown too big. The facial nerves control all facial movement and function. There is one on
the left side which operates the left side of the face and one on the right side which
operates the right side of the face. It is important that the nerve is not damaged during
the process of removing the tumour.
Surgeons are aware that damaging the facial nerve can happen and may try and repair
the nerve at the same time as removing the tumour; there are various surgical techniques
which are used.
More recently, radiation treatment has been used in the management of facial nerve
tumours. However, because these tumours are so rare, there is very little research to
support the arguments for or against this treatment approach. For small lesions,
stereotactic radiotherapy may be a consideration.
One of the major risks is damage to the facial nerve, resulting in weakness or paralysis of
the affected side of the face. If the facial nerve has been preserved, then facial function
should return, although not completely.
Hearing loss
Vertigo
Tinnitus
Infection
Bruising (haematoma)
Articles
Facial nerve schwannoma
Sam J. Marzo, Chad A. Zender and John P. Leonetti
Current Opinion in Otolaryngology & Head and Neck Surgery 2009,