ISPUB.COM The Internet Journal of Otorhinolaryngology Volume 4 Number 1 1 of 4 Intra Parotid Facial Nerve Schwannoma: A Case Report S Singhal, S Bansal, A Dass, A Tahlan Citation S Singhal, S Bansal, A Dass, A Tahlan. Intra Parotid Facial Nerve Schwannoma: A Case Report. The Internet Journal of Otorhinolaryngology. 2004 Volume 4 Number 1. Abstract Schwannoma is a benign, capsulated perineural tumour of neuroectodermal derivation that originates from the Schwann cells of the neural sheath of motor and sensory peripheral nerves: the etiology is still unknown. The tumour is usually solitary, smooth surfaced, slow growing and generally asymptomatic. Intraparotid facial nerve schwannomas are uncommon. These benign tumors of neurogenic origin should be considered in the differential diagnosis of parotid region masses. A case of facial nerve schwannoma from the buccal branch of intraparotid region is described with review of literature. The case is of interest due to the relative rarity of the pathology and presence of non-significant symptoms for a presumed initial clinical diagnosis. INTRODUCTION Schwannomas referred to as neurilemomas or neurinomas are benign, capsulated tumours of neuroectodermal derivation those originates from the schwann cells of the neural sheath of motor and sensory peripheral nerves; the etiology is still unknown. Although they may arise at any age, the peak incidence is between the third and sixth decades 1 . There is no gender predeliction. The tumour is usually solitary, smooth surfaced, slow growing and generally asymptomatic. Facial nerve schwannoma can arise from any segment of the nerve from the glial-schwann cell junction at the cerebellopontine angle to the peripheral branches in the face. Origin from intraparotid part of facial nerve is rare 2 . We present one such case, which underwent surgical excision of the tumor arising from the lower branch of facial nerve with preservation of facial function and review the literature. CASE REPORT A 25 year old female patient presented to the ENT department of our institute with a one year history of a gradually enlarging mass in the left infra auricular region. There was no history of facial weakness or pain. Examination revealed a 2x2 cm firm, non-tender, mobile mass below the left pinna. Facial nerve function along with other ENT examination was normal. FNAC was suggestive of a spindle cell tumor: Intraoperatively, the main trunk of the facial nerve was normal. Superficial parotidectomy was performed and a 3x2 cm mass arising from the buccal branch of facial nerve was seen Fig. 1(a). The mass was dissected free and removed from all the branches of the facial nerve except the buccal branch, which had become incarcerated into the mass. Post operatively; there was a transient weakness of the buccal branch of facial nerve, which gradually improved & three months later, the facial nerve function had significantly improved. Postoperative histological examination was suggestive of a benign schwannoma. On gross examination the mass measured 2x1.5cm. It was well encapsulated and cut section was gray white. Microscopic showed a spindle cell tumor with antoni A and B areas. Characteristic verocay bodies were also identified Fig.2 (b). Adjacent salivary gland tissue was not identified. Figure 1 Figure 1a: Intraoperative photograph showing the tumor arising from the buccal branch of the left facial nerve.