Schwannoma of the Facial Nerve Causing Sudden Facial Palsy: Report of Three Cases

Introduction: Facial nerve schwannomas are rare slow-growing tumors that can arise from any part of the facial nerve. Progressive and recurrent facial motor deficit are common findings. However, sudden appearance of a facial palsy should not rule out the diagnosis of facial schwannoma as an uncommon cause of the deficit. Surgery should be tailored to each case, with complete resection of the tumor and reconstruction of nerve as a goal. We report unusual cases of facial schwannoma with a sudden presentation of facial palsy. Methods: We performed a review of the cases treated by the authors with schwannomas involving the temporal bone, their symptoms, surgical approaches, and results. Results: We present three cases of facial schwannoma with sudden facial palsy as the first manifestation of the tumors. In two of them the geniculate ganglion was involved, and in the third case the tympanic and vertical segments were involved. Complete removal of the tumor could be achieved in the three cases, without any additional morbidity. One patient had a recurrence 3 years after the surgery. Conclusions: Facial nerve schwannoma should be considered in the differential diagnosis of facial nerve palsy, even in cases with abrupt onset.