ABSTRACT
Facial nerve tumours are rare. The most common histological type are facial nerve schwannomas (FNS) although facial nerve haemangiomas, malignant nerve sheath tumours and 'skip' lesions from parotid malignancies, amongst others, may also occur. This chapter focuses on FNS, their presentation, diagnosis and management, but will also consider the differential diagnoses for these lesions. The main differential diagnosis of an intratemporal facial nerve schwannoma is a facial nerve haemangioma. Bony erosion may not be smooth because haemangiomas do not have a capsule. They do not usually affect multiple segments as FNS do. Haemangiomas have been described as having a 'honeycomb' appearance on imaging. FNSs are rare and usually present with disturbance of facial function, with or without audiovestibular dysfunction. Management decisions must be tailored to each patient based on existing facial and audiovestibular function and tumour location but management philosophy varies between units internationally. The primary aim of management is preservation of optimal facial function for as long as possible.
