Intraparotid facial nerve schwannoma: A cross-country report of two cases and literature review

Abstract

Intraparotid facial nerve schwannoma (FNS) is very rare disease that is difficult to diagnose; thus, there is no established treatment strategy. We herein report two cases of intraparotid FNS and highlight the diagnostic and surgical approach. The first patient presented with painful parotid mass. We performed superficial parotidectomy as a diagnostic treatment. The continuity of the nerve was interrupted when we attempted to completely resect the tumor. After resection, we carried out reconstruction of the facial nerve using neurorrhaphy with end-to-end anastomosis. A histopathological examination revealed findings of intraparotid FNS. The House-Brackmann (HB) grade was II at a 2-year follow-up examination. No recurrence has been seen in the 2 years since surgery. The second patient presented with gradually progressive swelling in the right parotid region. The patient underwent tumor removal without parotidectomy via binocular magnification and a diode laser. As a result, the patient’s facial nerve function was intact at an 8-year follow-up examination (HB grade I). Tumor recurrence was not identified. Microsurgical and diode laser approaches in the management of intraparotid FNS resulted in a better overall facial nerve function without recurrence. Resection of intraparotid FNS with microsurgical and diode laser approaches should be included in a management algorithm, with prioritization of preservation of the facial nerve function.