Intraparotid Facial Nerve Schwannoma: A Comprehensive Review of 70 Cases at One Single Institution

ABSTRACT Objective The current study aimed to analyze the clinical characteristics, diagnosis, and surgical outcomes of intraparotid facial nerve schwannoma (IPFNS) and propose a more definitive therapeutic algorithm for IPFNS. Methods Between January 2018 and December 2023, all the cases of IPFNS at our single institution were retrospectively reviewed. Results In total, 70 patients were included in this study. Among them, 23 (32.3%) were men and 47 (67.7%) were women. The patients commonly presented with a painless parotid mass, and three patients complained of facial paralysis. Magnetic resonance imaging (MRI) had the highest diagnostic efficacy (37.1%) among all the evaluation techniques used. Marchioni's classification and surgical method were significantly associated with postoperative facial function. In terms of surgical interventions, stripping surgery was suitable for type A tumors, while for types B, C, and D tumors, intracapsular enucleation with a microscope was recommended to decrease the influence of the procedure on facial nerve function. Conclusions IPFNS is a rare disease, whose diagnosis and management remain challenging. MRI is the preferred preoperative diagnostic method. Preoperative facial nerve function, tumor location, and patients' preferences are key factors in the decision‐making process of IPFNS treatment.