The best candidates for nerve-sparing stripping surgery for facial nerve schwannoma

Objectives/Hypothesis Clinical decision making for facial nerve schwannoma is particularly complicated in patients with good facial nerve function; however, an early nerve‐sparing tumor resection stripping technique minimizes facial deficits associated with treatment. The present study characterized the optimal candidate for this nerve‐sparing surgical strategy in patients with good facial function. Study Design Retrospective study. Methods Nerve‐sparing stripping surgery was performed on 28 patients with facial nerve schwannoma. The House‐Brackmann grading system was used to assess pre‐ and postoperative facial function. We retrospectively analyzed pre‐ and postoperative facial function, duration of facial palsy, tumor size, and location and number of involved segments. The data were analyzed using Fisher exact test and independent t tests. Results Of the 28 patients, 18 successfully underwent stripping surgery and 16 had a favorable outcome. Favorable postoperative facial function was associated with good preoperative facial function (House‐Brackmann grade [HBG] ≤II); small, localized tumors; and tumors located in the geniculate ganglion and/or its proximal portion. Conclusions Patients with facial nerve schwannoma who have good preoperative facial function (HBG ≤2), tumor located in the proximal portion of the geniculate ganglion, and small tumors (