Endoscopic Transcanal Excision: a breakthrough in the treatment of facial nerve schwannoma.

About the Patient and condition

A 35-year-old female patient was presented at Apollo Cancer Centre, Bangalore who was suffering with right-sided facial weakness for past two years.

Case Scenario

Dr Satish Nair, Senior Consultant, ENT & Head and Neck Oncology at Apollo Cancer Centre, Bangalore performed an otoendoscopy on the patient which revealed a pinkish-pale non-pulsatile mass behind the intact tympanic membrane at the posterosuperior quadrant. Further detailed examination showed that the patient had right-sided Grade V lower motor neuronal facial palsy and high-resolution computed tomography of Temporal Bone revealed a mass in the facial recess eroding the posterior genu of the facial nerve, which suggested facial nerve schwannoma.

Dr Nair along with his team of medical experts performed endoscopic trans canal excision of the facial nerve schwannoma on the patient. This is for the first time in the world that the principles of head and neck, lateral skull-base approach, and endoscopic techniques were used together to retain the entire functionality of the ear.

The surgery lasted for two hours wherein the team of doctors performed endoscopic trans canal excision of facial nerve schwannoma with cable grafting using the greater auricular nerve. The patient was discharged on the second post-operative day without any complications.

Worldwide Scenario

Facial nerve schwannomas are rare slow-growing tumors, accounting for less than 1% of all temporal bone tumors. Schwannoma grows on the 7th cranial nerve or the facial nerve. It is a benign and slow-growing tumor, also known as a Facial Neuroma. The tumor arises from the Schwann cells which surround the axons of peripheral and cranial nerves. In India, the incidence of facial nerve schwannoma is 1 in 50,000.

Expertise at Apollo Hospitals

Dr Satish Nair, Senior Consultant, ENT & Head and Neck Oncology, Apollo Cancer Centre, Bangalore, said, “When we first came across this unique case, we knew the challenges in front of us but the confidence in the new age advanced technology ensured to give required results for the patient. The diagnosis revealed that the facial nerve schwannoma was in a complicated position and led to facial palsy. The surgery was a tough one but with the right technique and expertise, we were able to pull off the world’s first endoscopic trans canal excision of facial nerve schwannoma.”

Sharing his thoughts on the surgery, Dr Manish Mattoo, Chief-Executive Officer, Apollo Hospitals, Karnataka Region, said, “At Apollo Cancer Centre, we stand committed to our mission of providing the finest world-class treatments to the patients who put their trust and lives in the hands of our doctors and surgeons. The unique case addressed by Dr Nair has convinced us that if one pursues any case with passion and intellect, one can invent solutions to help patients in the best way possible.”

Apollo Hospitals – Touching Lives

With a focus on innovating new techniques for the treatment of rare cancer cases, Apollo Cancer Centre, Bangalore, has been at the forefront of battling cancer with advanced care.

Apollo’s vision is to deliberate the emerging trends in cancer management and their impact on clinical practice thus bringing a ray of hope to 3.5 billion people from over 147 countries. Since our focus has been on driving smarter, safer, and more effective treatments, oncologists at Apollo Cancer Centre, Bangalore, recently made a breakthrough in treating facial nerve schwannoma.

Apollo Cancer Centre, Bangalore is a comprehensive, multi-modality state-of-art cancer care facility with a coordinated multidisciplinary approach. Bringing together the latest technology and highly skilled health care professionals, ACC Bangalore has the unique advantage of being a stand-alone cancer unit having the most modern backup from all super specialty and diagnostic & support services including cytology, histopathology, haematology, pathology, radiology services including PET-CT, path lab, physiotherapy, blood bank and many more.

Patient’s testimonial

Patient expressed her heartfelt thanks to her treating doctor and the entire staff for the treatment and care extended at Apollo Hospitals.