Breakthrough In Facial Nerve Schwannoma Treatment, Indian Doctors Perform Endoscopic Transcanal Excision

For the first time in the world, endoscopic transcanal excision of facial nerve schwannoma was performed on a 35-year-old patient at Apollo Cancer Centre, Bangalore, India.

Facial nerve schwannoma, also known as a facial neuroma, is a benign and slow-growing tumor that grows on the 7th cranial nerve of the facial nerve. It arises from the Schwann cells which surround the axons of peripheral and cranial nerves. Facial nerve schwannomas are rare, accounting for less than 1 per cent of all temporal bone tumors. According to cancer.gov, it has affected fewer than 200,000 people across the globe. In India, the incidence of facial nerve schwannoma is 1 in 50,000.

Apollo Cancer Centre, Bangalore, recently made a breakthrough in treating facial nerve schwannoma. A team of medical experts at the hospital headed by Dr Satish Nair, Senior Consultant, ENT & Head and Neck Oncology, performed endoscopic trans canal excision of facial nerve schwannoma on a 35-year-old patient who was suffering from right-sided facial weakness for the last two years.

The hospital claims that this is for the first time in the world that the principles of head and neck, lateral skull-based approach, and endoscopic techniques were used together to retain the entire functionality of the ear.

Diagnosis of facial nerve schwannoma

The team did an otoendoscopy that revealed a pinkish-pale non-pulsatile mass behind the intact tympanic membrane at the posterosuperior quadrant. Further examination showed that the patient had right-sided Grade V lower motor neuronal facial palsy and her high-resolution computed tomography of Temporal Bone revealed a mass in the facial recess eroding the posterior genu of the facial nerve, which suggests facial nerve schwannoma.

According to Dr Nair, this was a unique case as the tumor sits in a complicated position, which led to facial palsy.

World's first endoscopic trans canal excision of facial nerve schwannoma

Following the diagnosis, Dr Nair's team decided to perform endoscopic trans canal excision of facial nerve schwannoma with cable grafting using the greater auricular nerve. The surgery lasted for two hours, and the patient was discharged on the second postoperative day without any complications.

Talking about their accomplishment, Dr Nair stated that the surgery was a tough one, but they were able to pull it off successfully with the right technique and expertise. He added that the patient is doing well now.