Management of Facial Nerve Schwannomas

Management of Facial Nerve Schwannomas
John Rutka

This short lecture concerns the management strategies involved with intratemporal facial nerve schwannomas. As in comedy timing of treatment seems to be the most important factor in these benign lesions. As a general rule treatment of facial nerve schwannomas is primarily conservative unless there is deterioration of facial function greater than that of a HB Grade III appearance. Many affected individuals can be monitored conservatively in strategies similar to those for vestibular schwannomas. In the author’s experience middle ear/mastoid decompression of the nerve in its intratemporal course maybe the better option for preservation of facial nerve activity when compared to resection followed by other forms of dynamic nerve reconstruction (ie facial-partial hypoglossal anastamosis, facial nerve interposition grafts etc).