A Rare Case With Mixed Growth of Facial Nerve Neurofibroma and Schwannoma Without Facial Paralysis

Facial neuromas are benign with a common clinical manifestation of gradual or sudden peripheral facial nerve paralysis. This study reports an atypical case of facial neuroma in the absence of facial nerve paralysis and discusses the diagnosis and pathophysiological features. A rare case of extensive facial neuroma histopathologically confirmed as a mixed growth of schwannoma and neurofibroma in a 51-year-old man was described. Analysis of the clinical manifestations and Computed Tomography/Magnetic Resonance Imaging (CT/MRI) characteristics was conducted, with documentation of the surgical intervention and associated complications. Intraoperative findings revealed complete destruction of the facial nerve structure, contrasting the patient's preoperative lack of facial paralysis. The patient underwent complete resection of the tumor followed by end-to-side neurorrhaphy of the facial nerve to the hypoglossal nerve by means of great auricular nerve grafting. Postoperative pathology showed mixed growth of schwannoma and neurofibroma. Postoperative follow-up showed no significant recovery of facial paralysis. To our knowledge, this is the first report of an extensive facial neuroma with a mixture growth of schwannoma and neurofibroma without facial paralysis. The clinical manifestations of facial neuromas are diverse, necessitating a differential diagnosis of each case of temporal bone tumor.