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Management of a facial nerve schwannoma with fractionated stereotactic radiotherapy: a case report

Published online by Cambridge University Press:  09 June 2023

Alia Mousli Open the ORCID record for Alia Mousli [Opens in a new window] ,
Hadhemi Ayadi ,
Amani Yousfi ,
Rim Abidi  and
Chiraz Nasr
Alia Mousli*
Affiliation:
Department of Oncology Radiotherapy, Institute of Salah Azaiez, Tunis, Tunisia University Tunis El Manar, Tunis, Tunisia
Hadhemi Ayadi
Affiliation:
Department of Oncology Radiotherapy, Institute of Salah Azaiez, Tunis, Tunisia
Amani Yousfi
Affiliation:
Department of Oncology Radiotherapy, Institute of Salah Azaiez, Tunis, Tunisia University Tunis El Manar, Tunis, Tunisia
Rim Abidi
Affiliation:
Department of Oncology Radiotherapy, Institute of Salah Azaiez, Tunis, Tunisia University Tunis El Manar, Tunis, Tunisia
Chiraz Nasr
Affiliation:
Department of Oncology Radiotherapy, Institute of Salah Azaiez, Tunis, Tunisia University Tunis El Manar, Tunis, Tunisia
*
Corresponding author: Alia Mousli, Department of Oncology, Radiotherapy, Institute of Salah Azaiez,Tunis, Tunisia; Email: alia_1709@LIVE.fr
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Abstract

Introduction:

Neuroma of the facial nerve (NFN) is an extremely rare benign tumour that can involve any segment of the facial nerve. It is revealed by facial weakness with or without hearing loss and has commonly been managed by microsurgery. Our purpose is to systematically review the literature about the role of fractionated stereotactic radiotherapy (FSRT) on the treatment of NFN.

Clinical case:

We report the case of a 70-year-old-woman who presented progressively worsening facial paralysis associated with mild conductive hearing loss and dizziness. The multimodal magnetic resonance imaging (MRI) was very suggestive of an intrapetrous neuroma, centred on the tract of the VII nerve and the left geniculate ganglion. She was treated by FSRT at the dose of 18 Gy in three fractions on the isodose line 80 %. After 18-month follow-up, she reported a facial weakness improvement. The MRI revealed a stable disease.

Conclusion:

The clinical presentation of the schwannoma of the facial nerve depends essentially on its location. It is therefore very variable, ranging from an isolated mild hearing loss to a vestibular syndrome with facial paralysis. Through this observation with literature review, we reported a long-term tumour control with improvement of pre-treatment symptomatology with FSRT.

Keywords

facial nerve neuromafractionated stereotactic radiotherapytumour controlbenign tumourfacial nerveneuroma
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e101
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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