Facial Nerve Tumors
There are several types of facial nerve tumors; facial nerve schwannomas are the most common. Facial nerve schwannomas are benign (non-cancerous) tumors that originate from Schwann cells, which are the cells that produce myelin sheaths covering nerve fibers. While most occur sporadically, facial nerve schwannomas can occur as part of genetic syndromes like Neurofibromatosis Type 1 or Neurofibromatosis Type 2. Most patients with a facial nerve tumor experience sudden or progressive facial weakness, symptoms similar to Bell’s Palsy. Hearing loss can also occur if the tumor compresses or invades structures associated with the hearing system. Conductive hearing loss may result if the tumor abuts the eardrum or the hearing bones within the middle ear. Sensorineural hearing loss may occur if the tumor is large enough to compress the auditory nerve or invade inner ear structures.
A complete history and physical examination is recommended for patients experiencing facial weakness/paralysis. Typically, the workup for this condition includes a comprehensive hearing test and for those with a normal in-office exam of the ear, an MRI scan of the Brain (with fine-cut internal auditory canal protocol) is obtained. If the examination of the ear is abnormal, a high-resolution temporal bone CT scan may be substituted instead. Typically, Dr. Jacob’s goal is to evaluate the entire course of the facial nerve (from brainstem into the parotid gland). Surgical recommendations are made on a case-by-case basis depending on the size and location of the tumor, hearing status and whether the nerve is weak or completely paralyzed. These tumors are typically slow growing and may not require treatment for years; however, they should be followed closely.