Intraoperative diagnosis of facial nerve schwannoma at parotidectomy

Abstract 

Objective

Our objective was to provide a diagnostic algorithm for facial nerve schwannomas presenting as a parotid mass.

Study design

The study is a case report and literature review.

Methods

A clinical case of a patient with an asymptomatic parotid mass diagnosed as a facial nerve schwannoma intraoperatively is presented. The patient's presentation and the diagnostic algorithm and surgical rationale are discussed. A review of the literature on facial nerve schwannomas is presented.

Conclusions

Intraparotid facial nerve schwannomas are an extremely rare entity and are rarely diagnosed preoperatively. Most of these benign lesions can be managed conservatively with the goal of preserving facial nerve function. Intraoperatively, fine-needle aspiration and/or conservative biopsy in a nonstimulating portion of the lesion can be used to make the diagnosis.