Case Report: Facial nerve schwannoma: comprehensive surgical management with nerve reconstruction and hearing rehabilitation

TL;DR

A 17-year-old girl with a facial nerve tumor underwent successful surgery and rehabilitation, improving her facial function and preserving hearing.

Contribution

A case report demonstrating successful surgical and rehabilitative strategies for facial nerve schwannoma.

Findings

Facial function improved from House-Brackmann grade V to III after surgery.

Hearing was preserved following the two-stage surgical approach.

Multidisciplinary management led to favorable functional outcomes.

Abstract

Facial nerve schwannomas are rare tumors that pose diagnostic and surgical challenges. We report a 17-year-old female with progressive right-sided facial paresis initially misdiagnosed as Bell's palsy. MRI revealed a contrast-enhancing lesion of the facial nerve. She underwent a two-stage surgery: tumor resection via mastoidectomy and hearing rehabilitation, followed by facial nerve reconstruction using masseteric-to-facial nerve transfer and cross-face sural grafting. At nine months postoperatively, facial function improved from House-Brackmann grade V to III, and hearing was preserved. Early imaging and multidisciplinary management can enable complete tumor resection with functional restoration and favorable outcomes.

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