A case of Intraparotid Facial Nerve Schwannoma

Abstract

Schwannomas are ectodermal benign encapsulated and slow growing neoplasms arising from the nerve sheath (Schwann cells). Schwannomas most   commonly involves vestibulocochlear nerve in head and neck, facial nerve is less likely and INTRAPAROTID FACIAL NERVE SCHWANNOMA(IFNS) is a rare condition which is being presented here. A 30 year old female admitted for swelling in the left parotid region. On examination 4x 4 cm nontender, firm, mobile swelling on the left side in the region of parotid gland with no signs of facial nerve palsy or cervical lymphadenopathy. FNAC of swelling was reported as myoepithelioma. Patient was planned for superficial   parotidectomy. Intraoperatively tumor located close to the nerve and splaying of nerve fibers around and within tumour was noted. Tumour was excised which was found to be schwannoma arising from facial nerve. Schwannomas of the facial nerve arise from either the extratemporal or  intratemporal course of the facial nerve. Most of these tumors are intratemporal, whereas 9 percent are located extracranially and usually appear as asymptomatic parotid masses. It is very difficult to diagnose intraparotid facial nerve schwannoma (FNS) preoperatively because its incidence is rare accounting for only 0.2-1.5 percent of parotid masses