Near-total removal of facial nerve schwannomas: long-term outcomes.

Objective: The study aimed to present long-term outcomes of near-total removal of facial nerve schwannomas (FNS) with good facial nerve function (HB Grade III or better).

Methods: We successfully performed near-total removal of FNS (tumor removal of 95% or greater) on 13 cases, and the remaining 6 cases who failed underwent total tumor removal and nerve grafting. Patients were divided into near-total removal group and total removal group according to surgical approach, and they were followed up for 7.38 ± 1.98 years (range, 5 to 11 years) and 6.66 ± 1.63 years (range, 5 to 9 years), respectively.

Results: 12 of 13 cases (92.3%) in the near-total removal group successfully maintained at least Grade III except one who recurred and underwent complete tumor removal and nerve grafting, and 10 cases (76.9%) achieved Grade I or Grade II. 5 of 6 cases (83.3%) in the total removal group obtained Grade III, but none recovered to Grade I or II. Tumor growth was noted in only one case (7.7%) among the near-total removal group during the follow-up.

Conclusions: Long-term outcomes of near-total removal of FNS were favorable, which may be a good choice for the old patients with good facial nerve function.