The patient was detected with Facial Nerve Schwannomas (FNSs)which is a rare benign tumour arising from the Schwann cells of the sheath of the facial nerve. The patient was unable to close her eyes, form wrinkles while smiling, blow or whistle

In a rare feat, a team led by Dr ChandraVeer Singh & Dr Sheetal Radia, Consultant Otorhinolaryngologist, and Head & Neck Oncosurgeon, Dr Vinod Rambal, Consultant Neurosurgeon, Wockhardt Hospitals, Mira Road successfully treated a 58-year-old woman with a rare benign tumour, Facial nerve schwannomas (FNSs) which was pressing her nerve invading the brain. She been discharged from the hospital and resumed her daily routine with ease She was admitted on 4th October, Surgery was done on 5th October & she was discharged on 8th October, 2023

Mrs Maragaret Fernandes, a resident of Wadala Experienced facial swelling, twitching, lump near her jaw, when her family took her to a city hospital that confirmed the diagnosis of Facial Nerve Schwannomas (FNSs).

Dr ChandraVeer Singh, Consultant Otorhinolaryngologist, and Head & Neck Oncosurgeon, Wockhardt Hospitals, Mira Road, said, “The patient presented with gradually enlarging, symptomatic swelling in her right parotid (major salivary glands) gland that had been present for 5 years. On examination, the CT scan revealed the presence of a 3 cm mobile mass which was nontender and firm in consistency.  The patient could not close her eyes and form wrinkles while smiling, eating, blowing, or whistling. There was facial asymmetry. However, the facial nerve conduction test (facial CMAP) was absent on the right side. No palpable cervical lymphadenopathy was found. The intraoral examination was normal. CT scan of the neck region revealed a dumbbell-shaped encapsulated mass of 5.6×5.7×4.6cm prominently along the facial nerve. MRI scan of the lesion one year back shows Well defined lobulated single intensity lesion of 2.0x x2.9×2.7cm in the deep lobe of the parotid.

Facial nerve schwannomas (FNSs) are rare benign tumours arising from the Schwann cells of the sheath of the facial nerve. Excessive multiplication and growth of Schwann cells of nerve sheath will lead to schwannoma. Only seven cases reported worldwide to date. These tumours may arise anywhere along the course of the facial nerve. Owing to their rarity and nonspecific clinical and radiological presentations, the preoperative diagnosis of FNSs is exceedingly difficult.”

Dr ChandraVeer Singh added, “A diagnosis of facial nerve trunk schwannoma on fine needle aspiration of the parotid gland was made. Intraoperatively, the tumour was completely excised by a parallel incision in the nerve sheath and the tumour was transacted.  The nerve reconstruction procedure was done. This technique is known as facial nerve-sparing surgery. The weight of the tumour was 50 grams. Not treating her at the right time could have led to complications like complete facial nerve palsy. Pressure symptoms of nerve tumours have all been resolved.”

“The tumour’s disfiguring effect on my face left me in shock and caused me to withdraw from society, fearing the inevitable questions that would arise. Unable to muster the courage to confront my reflection in the mirror, I found myself losing confidence and struggling with even basic tasks such as eating or smiling. However, thanks to the timely treatment provided by the doctors, I have regained control over my life and can now carry out all activities with ease,” concluded the patient, Margaret Fernandes.