Margit Eidenberger, University of Applied Sciences for Health Pro- fessions Upper Austria Campus Health Landes-Krankenhaus Steyr Bachelor Programme Physiotherapy Sierningerstr. 170, Austria Correspondence to: Margit Eidenberger, University of Applied Sciences for Health Professions Upper Austria Campus Health Landes-Krankenhaus Steyr Bachelor Programme Physiotherapy Si- erningerstr. 170, A-4400 Steyr, Austria. Email: Margit.Eidenberger@fhgooe.ac.at Telephone: +4350344262-23 Fax: +4350344212-99 Received: July 11, 2015 Revised: October 28, 2015 Accepted: November 3, 2015 Published online: November 10, 2015 ABSTRACT AIM: Facial paralysis is a common complication after Schwannoma surgery. Neural edema can be one of the reasons. Manual Lymphatic Drainage is the most efficient therapy in resolving lymphedemas, but has to date not been tried for facial paralysis in conjunction with Schwannoma surgery. It was therefore the aim of this paper to try Manual Lymphatic Drainage. MATERIALS AND METHODS: Case report of a 46-year old female Caucasian patient who has suffered from facial paralysis and intraoral seroma for one year after Schwannoma resection. Over that year, the facial paralysis showed a non-therapy-induced recovery of one degree on the House-Brackmann Facial Nerve Grading Scale. Three months prior to referral, a gold implant to facilitate eye closure was inserted in the upper eyelid. The patient suffered from eye region edema, redness in the eye region and conjunctiva, dry eye syndrome, a scraping feeling and glued eye. Conventional physiotherapy (facio-oral therapy, mimic exercises) showed no results. Six Manual Lymphatic Drainage treatments were performed. This led to a regression of the edema and the seroma after the first and the third therapy sessions, respectively. The facial paralysis improved by one degree (V-IV). As a consequence, the use of lubrication ointment could be reduced. CONCLUSION: Manual Lymphatic Drainage can be applied as an adjuvant therapy in Facial Paralysis and edema related to Schwannoma, which are not responsive to other therapies. CASE REPORT Manual Lymphatic Drainage with Facial Paralysis after Schwannoma: A Case Report Margit Eidenberger 356 Journal of Tumor 2015 November 10 3(3): 356-359 ISSN 1819-6187 Online Submissions: http://www.ghrnet.org/index.php/jt doi:10.17554/j.issn.1819-6187.2015.03.71 © 2015 ACT. All rights reserved. Journal of Tumor © 2015 ACT. All rights reserved. Key words: Schwannoma, Facial Paralysis, Manual Lymphatic Drainage Eidenberger M. Manual Lymphatic Drainage with Facial Paralysis after Schwannoma:A Case Report. Journal of Tumor 2015; 3(3): 356-359 Available from: URL: http://www.ghrnet.org/index.php/JT/ article/view/1451 INTRODUCTION Facial paralysis (FP) is a common complication after Schwannoma surgery (a benign tumor of the vestibulocochlearic nerve). The incidence ranges from 2 to 17% [1] and depends on tumor size [2] , the selected incision and whether intraoperative nerve monitoring was applied [3] . The severity of FP according to Kazim et al [4] is significantly higher in patients with tumors ≥ 4cm in diameter. The standard treatment of Schwannoma is surgery. Different techniques (e.g. retrosigmoidal, transtemporal, translabyrinthal) are possible. Morton et al [5] described edema formation, inflammation or circulatory disturbances as possible post-operative causes of FP. Further impairment of the nervous function can be due to the development of neural edema [6] . CASE PRESENTATION The case of a 46-year old female Caucasian patient with facial paralysis after Schwannoma resection is presented. This patient had suffered from unilateral hearing loss on the left side (Tinnitus and Tarditus) since May 2011. On 27th October 2011, an osteoplastic retro-mastoidal trepanation with microsurgical tumor extirpation of a Schwannoma grade IVa (2.5cm Ø) with displacement of the brain stem was performed on the left side. She was discharged after four days in intensive care and eight days on the general ward after inconspicuous primary wound healing. According to House- Brackmann Facial Nerve Grading Scale (HBFNGS), she was classified with facial paralysis grade VI. She was provided with a moister chamber to prevent eye exsiccation and medical supplements