Intratemporal Facial Nerve Schwannoma in a 5 Year Old Girl: A Therapeutic Dilemma.

IMAJ 2016; 18: 701–702 for evaluation. The parents reported worsening of the paralysis in the months prior to presentation. Her medical and surgical history was otherwise unremarkable. Physical examination revealed left peripheral facial nerve palsy, HouseBrackmann (HB) grade 5. The rest of the physical examination was normal. An audiogram recorded normal hearing. Magnetic resonance imaging (MRI) and computed tomography (CT) scans demonstrated an enlarged fallopian canal with a gadolinium-avid lesion extending from the mid-tympanic segment to the stylomastiod foramen compatible with a schwannoma [Figure 1]. No stigmata of neurofibromatosis were present. During surgery the tumor was found to extend from proximal to the cochleariform process to the neck just distal to the stylomastoid foraman. In its mastoid segment the tumor breached the fallopian canal towards the jugular bulb, and in its tympanic region reached the incus and pushed the stapes downwards towards the promontorium; the bulk of the tumor in this area prohibited preserving the posteF acial nerve schwannomas (FNS) are uncommon benign tumors that can arise from all segments of the facial nerve. Intratemporal schwannoma is a rare tumor in pediatric patients. Clinical manifestations may vary from none to facial paralysis, deafness, tinnitus, vertigo and an ear mass. We present the case of a child with an intratemporal FNS, and provide a detailed description of the diagnostic characteristics and the treatment dilemmas.