Facial nerve neuromas are rare benign tumours arising from the facial nerve anywhere from the brainstem to the peripheral branches after they have exited the stylomastoid foramen. We must always consider the very unlikely scenario that what appears to be a vestibular schwannma (acoustic neuroma) could represent a facial nerve schwannoma.
The most common presentation is that of a slowly developing facial palsy, sometimes in association with hearing loss and vestibular dysfunction.
Differential diagnoses to consider include invasion or compression from other pathology along the course of the facial nerve such as malignant tumours, perineural invasion, cholesteatoma, inflammatory lesions of the brain and skull base.
Large left facial nerve schwannoma
