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Facial nerve schwannomas tend to be overlooked due to their mild early clinical presentation and slow progression. To describe the role of facial nerve reconstruction in guiding the diagnosis and treatment strategy of facial nerve schwannoma. Multi-plane reformation (MPR) of the facial nerve was conducted to evaluate the facial nerve lesion segments, radiological characteristics, and mastoid decompression in 13 patients. Bone canal loss could be seen in lesions involving the geniculate ganglion and tympanic segment and those protruding toward the tympanum in two patients. Expansive space occupying lesions could be seen in the facial nerve involving the tympanic segment to the parotid segment in five patients. A ‘trumpet mouth’ spherical expansive space-occupying lesion centered in the mastoid segment and enlarged stylomastoid foramen could be seen in lesions involving the mastoid segment to the parotid segment in six patients. Treatment methods suitable for the patient were performed based on the facial palsy, tumor size, hearing loss, and social requirements. Facial nerve MPR reconstruction can comprehensively and intuitively display the lesion segment and area of the facial nerve in the temporal bone, estimate the facial nerve length, bone encapsulation, and mastoid decompression, and has characteristic presentations that can aid preliminary diagnosis and identification.

Role of MPR image reconstruction in guiding the diagnosis and treatment strategy of facial nerve schwannoma