Diagnosis and management of intraparotid facial nerve schwannoma

Summary Objective Our objective was to provide the management guidelines for facial nerve schwannomas (FNSs) presenting as a parotid mass. Study design The study is a case report and literature review. Methods Four clinical cases of patients with an asymptomatic parotid mass diagnosed as FNS are presented. The patient's presentation, the diagnostic algorithm and surgical rationale are discussed. A review of the literature on FNSs is presented. Conclusions Intraparotid FNSs are an extremely rare entity and are rarely diagnosed preoperatively. Intraoperatively, conservative biopsy in a non-functional part of the lesion can be used to make the diagnosis. Most of the FNSs of patients with normal facial nerve function could be dissected off the nerve trunk without losing FN function. FNS patients with preoperatively abnormal FN function should be managed conservatively or undergo reconstruction with nerve graft after tumour resection.