Management of intratemporal facial nerve schwannomas: The evolution of treatment paradigms from 2000-2015

Figure 2 Radiographic images of facial nerve schwannoma. A: Contrasted coronal T1 weighted MRI of right intracanilicular FNS. The patient was presumed to have a vestibular schwannoma but the tumor arose from the FN. The patient underwent tumor debulking with HB grade 1 at follow-up; B: Contrasted T1 weighted coronal MRI of a large FNS arising from the geniculate ganglion with significant extension into the middle fossa and the middle ear. The patient underwent a translabryinthine resection with cable grafting; C: Post contrast axial T1 weighted MRI demonstrating a FNS involving multiple levels of the facial nerve. This is a typical appearance of the “beads on a string” pattern of tumor growth (arrrowheads); D: Axial bone window high resolution computer tomography of the temporal bone demonstrating a large FNS of the mastoid segment causing erosion of both the bony ear canal (arrowhead) and the posterior fossa plate. MRI: Magnetic resonance imaging; FNS: Facial nerve schwannoma; HB: House-Brackmann.