Intraparotid facial nerve schwannoma. What to do?

An intraparotid facial nerve schwannoma is often not recognised in pre-treatment work-up and frequently results in subsequent significant postoperative morbidity. We have evaluated the literature regarding pre-treatment work-up and facial nerve function outcome. Two of our own cases are presented. A minority of the intraparotid schwannomas can be removed by resection while preserving facial nerve integrity and function. In the event of preoperative facial nerve dysfunction, tumour resection and subsequent nerve repair should be considered. If resection of an intraparotid facial nerve schwannoma cannot be performed with preservation of facial nerve integrity and function, a wait-and-see policy seems justified due to the indolent behaviour of the tumour and moderate results of facial nerve reconstruction.