Management of Facial Nerve Schwannoma Occluding the External Auditory Canal

Facial nerve schwannomas (FNSs) eroding through the external auditory canal (EAC) are unusual and present difficult management options.When facial nerve function is normal, observation is generally recommended.If the tumor completely obstructs the EAC creating a conductive hearing loss as in this case, mapping of the motor fibers of the facial nerve may be considered with partial resection to alleviate the conductive hearing loss.Test injection of a small volume of lidocaine did not cause facial paresis.Intraoperative mapping allow successful tumor debulking and wide patency of the EAC. Laryngoscope, 135:1809-1814, 2025.