Facial Nerve Outcomes in Facial Nerve Schwannomas

Objective: To better understand the characteristics and outcomes of facial nerve schwannomas (FNSs) over a 30-year period. Study Design: Retrospective study. Setting: Subspecialty practice at a tertiary hospital. Patients: Fifty-six patients diagnosed with FNS over a 30-year period. Methods: Preoperative data (audiologic data, facial nerve [FN] function, and patient symptoms), intraoperative data (tumor location, total versus subtotal resection, and FN status), and postoperative data (audiologic data, FN function, and recurrence) were collected. Mann-Whitney and chi(2) analyses were done to determine which factors correlated with poor FN outcomes (defined as House-Brackmann >= 4). Results: Of the 56 patients in this study, 53 (94.6%) underwent surgical resection of their FNS. Of those patients, 45 (84.9%) underwent total resection, and 8 (15.1%) underwent subtotal resection. Subtotal resection was associated with a statistically significant decreased risk of having postoperative HB grade >= 4 (odds ratio, 0.09; 95% confidence interval, 0.01-0.77; p = 0.028). Of those undergoing a subtotal resection, no patient had further tumor growth seen on postoperative magnetic resonance imaging (average time of last magnetic resonance imaging since operation, 44.9 mo). Tumor location was not statistically associated with poor FN outcome (all p > 0.05). Preoperative FN paralysis was the only preoperative clinical finding statistically associated with poor FN outcomes (p = 0.004). Conclusion: We have identified multiple characteristics of FNS as well as multiple factors associated with increased statistical risk of poor FN outcomes.