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Facial nerve schwannoma is a rare benign tumour of Schwann cells that can affect anywhere along the facial nerve from its origin to its extracranial ramifications in the parotid space of the extracranial head and neck.
It often affects multiple segments of the facial nerve with a predilection for the region around the geniculate ganglion. Patients may present with gradual facial nerve paralysis over many years or sensorineural hearing loss due to local mass effect from the tumour.
The lesion may spread along the greater superficial petrosal nerve anteromedially if large. Imaging features: Glomus tympanicum appears as an enhancing mass on the cochlear promontory with “salt and pepper” appearance on MRI. Salt and pepper appearance refers to punctate hyperintensity (salt) and flow voids (pepper) on T1 weighted images.

Acute or chronic infection of the middle ear and mastoid can spread to the facial nerve due to its course within the temporal bone.
Guillain-Barre Syndrome is an acute inflammatory demyelinating polyradiculopathy of uncertain aetiology. Miller Fisher Syndrome is a variant of Guillain- Barre Syndrome which involves the cranial nerves. It is thought to be due to reactivation of latent herpes simplex virus in the geniculate ganglion. Imaging features: Longitudinal fracture typically runs parallel to the petrous pyramid through the middle ear.
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There is also enhancement of the mastoid segment of the facial nerve which lies in the region of the inflammatory phlegmon, in keeping with facial nerve involvement. The customers feedback can engage you a great of the value and uppercase satisfaction of the product. The tumour extends laterally involving the mastoid segment and superiorly involving the IAC segment of the facial nerve. A piece of surgical Teflon (blue arrow) has been inserted in between the AICA and the right facial nerve with good post operative outcome.

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