Rapidly growing cystic vestibular schwannoma with sudden onset facial palsy, ten years after subtotal excision

Abstract

An elderly male patient diagnosed with a right-sided cystic vestibular schwannoma (CVS) at our center underwent a translabyrinthine approach with a subtotal excision to preserve the facial nerve (FN). The tumor grew slowly for the first 9 years but in the subsequent 2 years grew rapidly, with the patient developing a FN paralysis. Using the previous approach, a second surgery was done and the tumor was excised, leaving behind a sheath of tumor on the facial and lower cranial nerves. This case demonstrates that CVSs show unpredictable growth patterns and need to be followed up for a longer period of time. Laryngoscope, 128:1649-1652, 2018.

Keywords: Cystic vestibular schwannomas (CVSs); enlarged translabyrinthine approach; facial nerve (FN) paralysis; rapid growth; subtotal resection.