JMCR: Clinical Minute

Facial nerve schwannoma presenting as an occluding external auditory canal mass: a case report and review of the literature.

Published in Biomedical Research

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Article Highlights

  • Describes a facial-nerve schwannoma presenting as an occluding external auditory-canal mass.
  • Demonstrates preserved facial function despite tumor origin from the facial nerve.
  • Identifies smooth posterior canal-wall erosion near the mastoid facial-nerve segment as an important CT clue.
  • Shows how the lesion may mimic an aural polyp, cholesteatoma, ceruminous tumor, paraganglioma, or malignancy.
  • Reinforces the risk of facial-nerve injury from an inadequately planned biopsy.
  • Confirms the diagnosis histologically through Antoni A and B architecture and strong S-100 expression.

Clinical Take-Home Message

Normal facial function does not exclude a facial-nerve schwannoma.

A posterior external auditory-canal mass—particularly one accompanied by smooth canal-wall erosion—should be imaged and assessed for a possible facial-nerve origin before biopsy or excision. CT defines the bony anatomy, while MRI generally provides the best confirmation of neural origin and tumor extent.