{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:54:37Z","timestamp":1786125277113,"version":"build-2736575974"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Facial nerve schwannomas are rare and can arise from any segment along the course of the facial nerve.\n                    <jats:sup>1<\/jats:sup>\n                    Their location and growth patterns present as distinct groups that warrant specific surgical management and approaches.\n                    <jats:sup>2<\/jats:sup>\n                    The management challenge arises when the facial nerve maintains good function (House-Brackmann grade I-II).\n                    <jats:sup>3<\/jats:sup>\n                    Hence, a prime goal of management is to maintain good facial animation. In large tumors, however, resection with facial nerve function preservation should be sought and is achievable.\n                    <jats:sup>4,5<\/jats:sup>\n                  <\/jats:p>\n                  <jats:p>\u2003While tumors originating from the geniculate ganglion grow extradural on the floor of the middle fossa, they may extend via an isthmus through the internal auditory canal to the cerebellopontine angle forming a dumbbell-shaped tumor. Despite the large size, they may present with good facial nerve function. These tumors may be resected through an extended middle fossa approach with preservation of facial and vestibulocochlear nerve function.<\/jats:p>\n                  <jats:p>\u2003The patient is a 62-yr-old man who presented with mixed sensorineural and conductive hearing loss and normal facial nerve function. Magnetic resonance imaging (MRI) revealed a large tumor involving the middle fossa, internal auditory meatus, and cerebellopontine angle.<\/jats:p>\n                  <jats:p>\n                    \u2003The tumor was resected through an extended middle fossa approach with a zygomatic osteotomy and anterior petrosectomy.\n                    <jats:sup>6<\/jats:sup>\n                    A small residual was left at the geniculate ganglion to preserve facial function. The patient did well with hearing preservation and intact facial nerve function. He consented to the procedure and publication of images.\n                  <\/jats:p>\n                  <jats:p>\n                    \u2003Image at 1:30 \u00a9 Ossama Al-Mefty, used with permission. Images at 2:03 reprinted from Kadri and Al-Mefty,\n                    <jats:sup>6<\/jats:sup>\n                    with permission from JNSPG.\n                  <\/jats:p>","DOI":"10.1093\/ons\/opab335","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T20:22:44Z","timestamp":1632514964000},"page":"E530-E531","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Resection of a Dumbbell-Shaped Facial Nerve Schwannoma With Preservation of Facial Nerve Function Through the Extended Middle Fossa Approach: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"21","author":[{"given":"Kaith K","family":"Almefty","sequence":"first","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenya Linda","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4640-0563","authenticated-orcid":false,"given":"Walid","family":"Ibn Essayed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ossama","family":"Al-Mefty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12]]},"reference":[{"issue":"1","key":"bib2-20250821","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5152\/dir.2015.15060","article-title":"Imaging of facial nerve schwannomas: diagnostic pearls and potential pitfalls","volume":"22","author":"Mundada","year":"2015","journal-title":"Diagn Interv Radiol"},{"issue":"10","key":"bib3-20250821","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1002\/lary.22141","article-title":"Evolution in the management of facial nerve schwannoma","volume":"121","author":"Wilkinson","year":"2011","journal-title":"Laryngoscope"},{"issue":"2","key":"bib4-20250821","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1177\/0194599820913639","article-title":"Facial schwannoma management outcomes: a systematic review of the literature","volume":"163","author":"Bartindale","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"bib5-20250821","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/00129492-200303000-00031","article-title":"Fascicle preservation surgery for facial nerve neuromas involving the posterior cranial fossa","volume":"24","author":"Nadeau","year":"2003","journal-title":"Otol Neurotol"},{"issue":"3","key":"bib6-20250821","doi-asserted-by":"crossref","first-page":"517","DOI":"10.3171\/jns.2004.100.3.0517","article-title":"The anatomical basis for surgical preservation of temporal muscle","volume":"100","author":"Kadri","year":"2004","journal-title":"J Neurosurg"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ons\/article-pdf\/21\/6\/E530\/41121296\/opab335.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:53:00Z","timestamp":1786121580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,24]]},"references-count":5,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opab335","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,24]]},"assertion":[{"value":"2021-03-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}