Huge facial schwannoma extending into the middle cranial fossa and cerebellopontine angle without facial nerve palsy - Case report

A 46-year-old male presented with a huge facial schwannoma extending into both the middle cranial fossa and the cerebellopontine angle but without manifesting facial nerve palsy. Neurological examination on admission revealed no deficits except for speech disturbance. Computed tomography showed a multicystic tumor extending into the middle cranial fossa and the cerebellopontine angle, with destruction of the petrous bone. The tumor was totally grossly removed. Histological examination identified schwannoma. Total facial nerve palsy appeared postoperatively, but hearing acuity was preserved at a useful level. Facial nerve palsy is one of the most typical symptoms in patients with facial schwannoma, but is not always manifested even if the tumor extends into both the middle cranial fossa and the cerebellopontine angle.