Intraparotid Facial Nerve Schwannoma

Abstract Facial nerve schwannoma is a rare benign tumor, and intraparotid involvement is particularly uncommon, often leading to diagnostic difficulty. We report a case of an intraparotid facial nerve schwannoma incidentally identified during superficial parotidectomy in a patient with a long-standing parotid mass, nondiagnostic fine-needle aspiration cytology, and mild preoperative facial weakness (House–Brackmann Grade II). Intraoperatively, a bilobed lesion arising from the pes anserinus was encountered. A nerve-preserving surgical strategy was performed, consisting of selective excision of the lateral lobular component while preserving the main trunk and facial nerve continuity. Facial nerve function showed progressive improvement, with marked recovery at 6 months postoperatively and only mild residual weakness limited to the forehead. This case highlights the diagnostic challenges of intraparotid facial nerve schwannoma and supports the feasibility of nerve-preserving surgery in selected patients.