Volume 103 · Issue 44 · 2023

Facial nerve tumors are rare but challenging diseases, and accurate diagnosis and effective treatment are crucial for patients′ recovery. This article aims to explore the current status, challenges, and opportunities in improving the diagnosis of facial nerve tumors and its functional surgery. Imaging techniques such as MRI and CT play a crucial role in the preoperative diagnosis and evaluation of facial nerve tumors. However, limitations still exist in the imaging diagnosis of lesions isolated within the internal auditory canal and parotid gland. Surgical treatment is the main therapeutic approach for facial nerve tumors, and with the continuous development of surgical techniques, the surgical goals for facial nerve tumors have shifted from simply completely removing the tumor to preserving facial nerve integrity as much as possible and promoting postoperative facial nerve function recovery. Challenges faced in the diagnosis of facial nerve tumors and its functional surgery include limitations in imaging diagnosis, intraoperative facial nerve protection, and postoperative improvement of facial nerve function. Future directions include the application of high-resolution imaging techniques, innovation in nerve protection and repair surgical techniques, the realization of personalized precision medicine, and multidisciplinary collaboration. Future research and technological innovations are expected to overcome diagnostic difficulties, improve facial nerve preservation, and promote postoperative facial nerve function recovery.

Tumors originating from the facial nerve are relatively rare and primarily include three types: facial nerve schwannoma, facial nerve neurofibroma, and facial nerve hemangioma. The Facial Nerve Tumor Diagnosis and Treatment Consensus Writing Group of China has established the current consensus after multiple discussions, based on a review of domestic and international literature and taking into account the domestic situation. This consensus systematically elucidates the epidemiology, pathological characteristics, and main clinical manifestations of facial nerve tumors. It establishes diagnostic criteria for facial nerve tumors, clarifies the anatomical classification of facial nerve tumors, and outlines its main differential diagnoses. Furthermore, the consensus clearly defines the principles of applying different treatment methods for facial nerve tumors and outlines a concise workflow for the diagnosis and treatment of facial nerve tumors.

To evaluate the effect of greater auricular nerve interposition grafting in the treatment of facial nerve defect, and explore the prognostic factors.

The clinical data of patients who received greater auricular nerve interposition grafting in the Department of Otolaryngology Head and Neck Surgery of the Chinese PLA General Hospital from January 2010 to December 2021 were retrospectively collected, and efficacy of the surgery was evaluated. Univariate and multivariate ordinal logistic regression models were used to determine the prognostic factors.

Eighty-four patients were collected, of whom 39 (46.4%) were male and 45 (53.6%) were female, with an average age of (38.6±12.6) years. Facial nerve defect was caused by four kinds of primary diseases: benign facial nerve tumor (54 cases, 64.3%), other tumors (5 cases, 6.0%), iatrogenic facial nerve injury in middle ear surgery (19 cases, 22.6%), and cholesteatoma (6 cases, 7.1%). The median preoperative facial paralysis duration was 6 (1, 12) months. Preoperatively, there were 7 (8.3%) patients of House-Brackmann (HB) grade Ⅰ, 6 (7.1%) of grade Ⅱ, 11 (13.1%) of grade Ⅲ, 14 (16.7%) of grade Ⅳ, 19 (22.6%) of grade Ⅴ, and 27 (32.1%) of grade Ⅵ. Postoperatively, there were 46 (54.8%) patients recovered to grade Ⅲ, 26 (31.0%) to grade Ⅳ, and 12 (14.3%) to grade Ⅴ, and the overall postoperative HB grade declined compared with the preoperative HB grade (Z=-4.264, P<0.001). For all kinds of primary diseases, higher preoperative HB grade (OR=1.423, 95%CI: 1.031-1.966, P=0.032) and longer preoperative facial paralysis duration (OR=1.020, 95%CI: 1.007-1.034, P=0.003) correlated with poorer prognosis. Gender, age, side, facial paralysis onset(sudden or progressive), facial electromyography result (fibrillation potential), surgical approach, location of proximal anastomosis, length of facial nerve defect, and anastomosis technique were not correlated with postoperative facial function grade (all P>0.05).

The best outcome of great auricular nerve interposition grafting in the treatment of facial nerve defect is HB Ⅲ, which could be obtained by more than half of the patients. Higher preoperative HB grade and longer preoperative facial paralysis duration are risk factors to a poorer prognosis.

To explore factors affecting facial nerve function after surgery of large acoustic neuroma.

The data of patients with large acoustic neuroma who underwent microsurgery by the enlarged translabyrinthine approach in the Department of Otolaryngology-Head and Neck Surgery of Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital between April 2015 and April 2022 were retrospectively analyzed. According to the House-Brackmann (HB) grading system, facial nerve function of all patients before surgery, within 2 weeks and 1 year after surgery was evaluated. Multivariate logistic analyses were used to assess the related factors affecting facial nerve function in patients with large acoustic neuroma.

A total of 102 patients were collected, including 44 males (43.1%) and 58 females (56.9%), with a mean age of (49.9±11.4) years. The gross total resection rate was 90.2% (92/102) and there were no perioperative deaths. The follow-up time was 2 (1, 5) years. The good (HB Ⅰ-Ⅲ) rate of early postoperative (2 weeks after surgery) and long-term (1-year follow-up) facial nerve function was 73.5% (75/102) and 87.3% (89/102), respectively. Multivariate logistic regression analysis showed that facial nerve detection threshold>0.05 mA at the end of surgery (OR=6.782, 95%CI: 1.520-30.272, P=0.012 and OR=11.455, 95%CI: 2.182-60.146, P=0.004) was associated with poor functional recovery of facial nerve after surgery for large acoustic neuromas.

The short-term and long-term facial nerve function after surgery correlates with threshold value of facial nerve detection at the end of surgery. The threshold≤0.05 mA indicates that the facial nerve function may recover well after the surgery.

To elucidate the clinical manifestations, surgical management, nerve repair and outcomes of facial nerve hemangiomas.

The data of patients with facial nerve hemangiomas in the Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital from January 2010 to December 2021 were retrospectively analyzed. Appropriate surgical approach was selected based on the clinical manifestations, facial nerve function and imaging features of each patient. The facial nerve function was followed up after operation to analyze the therapeutic effect.

A total of 20 patients were in the final analysis, including 10 males and 10 females, with a mean age of (36.4±10.7) years (18-56 years). Facial nerve hemangioma successively manifested as facial paralysis (18 cases, 90.0%), hearing loss (11 cases, 55.0%), tinnitus (8 cases, 40.0%), and facial spasm (4 cases, 20.0%) according to the probability of onset. Intraoperative exploration showed that 65.0% (13/20) of the patients had multiple segments involvement, with the geniculate ganglion (16 cases, 80.0%), horizontal segment (11 cases, 55.0%) and labyrinthine segment (7 cases, 35.0%) of the facial nerve being most commonly involved. The tumor size and scope of involvement were determined according to the preoperative imaging examination, and the appropriate surgical approaches were selected based on hearing conditions, including the trans-mastoid approach in 5 cases, the trans-labyrinth approach in 5 cases, and the trans-middle fossa approach in 10 cases. Facial nerve repair was simultaneously performed in 19 patients, among which 2 patients underwent facial nerve re-route end-to-end anastomosis, 8 patients received great auricular nerve graft, 2 patients were subjected to facial nerve-hypoglossal nerve anastomosis, and 7 patients were subjected to facial nerve decompression. The House Brackmann (HB) grading scale was used to evaluate the facial nerve function. The longest follow-up time was 159 months, the shortest follow-up time was 17 months, and the average follow-up time was (81.9±39.3) months. There were 2 cases of grade Ⅰ (10.0%), 5 cases of grade Ⅳ (25.0%), 7 cases of grade Ⅴ (35.0%), and 6 cases of grade Ⅵ (30.0%) in the preoperative facial nerve function analysis. And 1 case of grade Ⅰ (5.0%), 10 cases of grade Ⅲ (50.0%), 8 cases of grade Ⅳ (40.0%), and 1 case of grade Ⅴ (5.0%) were in the postoperative facial nerve function analysis. The facial nerve function after operation was better than that before operation (H=13.683, P<0.001).

The possibility of facial nerve tumors should be taken into account under the condition of unknown facial paralysis, hearing loss and facial spasm. The characteristic CT images of the temporal bone are crucial for the diagnosis and differential diagnosis of facial nerve hemangioma. Surgical treatment and facial nerve repair are conducive to a favorable facial nerve function after surgery.

To investigate the short-and long-term facial nerve function after intratemporal facial nerve rerouting in lateral skull base surgery, and compare the differences in the facial nerve function following complete or partial rerouting.

This study retrospectively identified patients who underwent facial nerve rerouting to remove the tumors in lateral skull base area at Peking Union Medical College Hospital from July 2015 to August 2022. Demographic information, surgical records and follow-up results were analyzed. The House-Brackmann (HB) grading system was applied to analyze the facial nerve function and the data were recorded before and 1-2 weeks after the surgery, and at the last follow-up. The time when the patients′ facial nerve function recovered to HBⅠ-Ⅱ level was recorded. Additionally, other factors influencing the postoperative function of facial nerve were analyzed.

A total of 33 patients were in the final analysis, including 8 males and 25 females, with an average age of (44.6±12.2) years. Twenty-five patients underwent complete facial nerve rerouting and 8 patients received the partial rerouting. At the last follow-up, 30 patients (90.9%) showed a pleasant recovery of facial nerve function with HBⅠ-Ⅱ level. The infratemporal fossa type A approach was the most frequently applied management (25 patients, 75.8%). The two rerouting methods had no significant difference in the facial nerve function both at 1-2 weeks after the surgery and the long-term follow-up (both P>0.05). Furthermore, comparing the different facial nerve results revealed that carotid aneurysm (OR=26.496, 95%CI: 1.008~695.757, P=0.049) and large amount of intraoperative bleeding (OR=1.196, 95%CI: 1.021~1.401, P=0.026) were correlated with relatively weak facial nerve function after the surgery.

The facial nerve dysfunction caused by anterior rerouting could basically recover to HBⅠ-Ⅱ level and there is no difference in postoperative facial nerve function between complete and partial rerouting. In addition, increased intraoperative hemorrhage is a potential risk factor for poor facial nerve function after the surgery.

To investigate the safety and efficacy of regional parotid gland resection with small incision under microscope.

The data of patients who underwent parotid tumor resection with small incision under microscope from January 2017 to November 2022 were retrospectively collected. The patients′ basic information, preoperative imaging data, intraoperative relevant information, and follow-up data were evaluated, and the occurrence of complications was analyzed.

A total of 78 patients were enrolled, including 36 males and 42 females, with a median age of 37 (28, 48) years. The operation time was (88.5±24.6) minutes. The amount of bleeding was (16.2±7.2) ml. The maximum diameter of tumors was less than 3.5 cm, and all the tumor was located in the superficial lobe of the parotid gland. The pathological results were all benign. The follow-up time was 3-60 months. There was no tumor recurrence and permanent facial nerve injury, and no other complications such as salivary leakage and infection occurred.

Regional parotid resection with small incision under microscope is feasible, and its safety and efficacy need more cases and long-term follow-up studies.

To explore the value of CCDC12 gene methylation levels in peripheral blood and breast cancer.

A Case-control studies with a ratio close to 1∶1 were used. Peripheral blood samples from breast cancer patients and healthy controls were collected from three centers, namely the Cancer Hospital of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, and the First Affiliated Hospital of Zhengzhou University, from April 2018 to December 2022 were collected from multiple centers, and the methylation level of CCDC12 in peripheral blood was determined by time-of-flight mass spectrometry. The correlation of CCDC12 methylation and breast cancer was analyzed by logistic regression. The methylation levels of each molecular subtypes and control groups were compared by non-parametric comparison. AUC assesses the efficacy of methylation of this gene in diagnosing breast cancer.

Ultimately 289 female breast cancer patients with the median age of 50.0 years and 320 healthy women with the median age of 46.0 years were included in this study. The results of logistic regression analysis showed that hypermethylation at the four loci of CCDC12_CpG_6.7, CCDC12_CpG_10 and CCDC12_CpG_11 was closely related to breast cancer (OR:1.26, 1.18, 1.20 respectively, P<0.02). Similar results were obtained by stratified age 50. Even in early-stage breast cancer, the gene showed significant elevated methylation levels (CCDC12_CpG_6.7, CCDC12_CpG_10, CCDC12_CpG_11, OR: 1.16-1.21, P<0.05); The above four CpG loci were significantly elevated in patients with HER2-amplifying breast cancer compared with the control group (P<0.002).

Hypermethylation of CCDC12 gene is strongly associated with breast cancer.

To observe the clinical characteristics of patients with hemoptysis, and to evaluate the prognosis of these patients receiving selective arterial embolization (SAE) treatment.

Hospitalized patients with hemoptysis underwent SAE treatment in the Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Jianghan University from July 2017 to July 2020 were selected and followed up for 2 years. The etiology of hemoptysis, angiographic findings, blood supply vessels, surgical complications and postoperative recurrence of hemoptysis were analyzed.

A total of 1 211 patients were treated with digital subtractive angiography (DSA) and SAE. The most frequent underlying disease was bronchiectasis with infection in 654 cases (54.0%), followed by pulmonary tuberculosis in 144 cases (11.9%), pulmonary malignancy in 128 cases (10.6%) and pneumonia in 116 cases (9.6%). The main pathological features of target vessels under DSA were thickening and tortuosity, increasing and disorganization of peripheral branches, abnormal communication between body arteries and pulmonary circulation, aneurysm or aneurysm-like ectasia. A total of 6 540 responsible vessels were embolized in 1 211 patients, and the average number of embolized vessels was 5.4±3.7, including 2.5±1.0 bronchial arteries (BA) and 3.5±2.0 non-bronchial body arteries (NBSA), respectively. The total effective rate of SAE was 94.0% (1 138/1 211). A total of 1 026 cases completed the follow-up, 208 patients had recurrent hemoptysis within 2 years, and the recurrence rate was 20.3%. Compared with the non-recurrence group, the number of responsible vessels, the number and the proportion of NBSA were significantly higher in the recurrence group, while the proportion of pulmonary vascular intervention combined with respiratory endoscopic intervention was significantly lower. Intraoperative and postoperative complications occurred in 481 cases (39.72%), mainly including chest and back pain in 385 cases (31.79%) and fever in 142 cases (11.73%).

The main cause of hemoptysis in adults is bronchiectasis combined with infection. Both BA and NBSA are the main responsible vessels of hemoptysis. The more complex the target vessel, the higher the number and proportion of NBSA, the more prone to recurrence. SAE is a safe and effective method for the treatment of hemoptysis.

To evaluate the immunogenicity and safety of a quadrivalent inactivated subunit influenza vaccine among≥3-year-old healthy vaccinated population.

Healthy subjects≥3 year old were recruited for a randomized, blinded, positive-controlled phase Ⅲ clinical trial in two areas of Henan province. Subjects were randomly assigned in a 1∶1 ratio to receive either a quadrivalent inactivated subunit influenza vaccine (trial group) or a quadrivalent inactivated split-virion influenza vaccine (control group). Subjects in the age group of 9 years and above received 1 dose, and subjects in the age group of 3-8 years received 2 doses (28 days apart). We collected sera samples at baseline and at day 28. Influenza-specific HI antibody titers were used to evaluate the immune response and geometric mean titers (GMT), geometric mean increase (GMI), seroconversion rates (SCR) and seroprotection rates (SPR), non-inferiority comparison of GMT ratios and positive conversion rate differences for each virus type were done in the test and control group. All adverse reactions within 30 days and serious adverse events within 6 months post-vaccination were collected, and the incidence of adverse reactions was compared between the two groups.

There were 1 504 males out of 3 000 subjects (50.13%). 28 days after 1 dose in the population aged 3 years or older, the GMT (95%CI) against four serotypes H1N1, H3N2, BV, and BY in the test group and the control group were 400.54 (377.27-425.25) vs 333.39 (315.47-352.33), 438.38 (412.57-465.81) vs 385.00 (362.13-409.32), 77.31 (73.06-81.82) vs 67.62 (63.94-71.51), 266.52 (250.99-283.01) vs 180.26 (169.99-191.17), respectively (all P values<0.05); and seroconversion rates (95%CI) to four serotypes were 82.73% (80.70%-84.62%) vs 78.56% (76.39%-80.62%), 91.23% (89.67%-92.62%) vs 89.25% (87.56%-90.78%), 84.89% (82.96%- 86.67%) vs 80.98% (78.89%-82.95%), 88.33% (86.58%-89.92%) vs 81.92% (79.87%-83.85%), the differences between which were statistically significant (all P values<0.05), except for H3N2. All the lower limits of the 95%CI of the GMT ratios for the four serotypes in the test and control groups were>2/3, and all the lower limits of the 95%CI of the difference in positive transfer rates were>-10%, which indicated that the immunogenicity of the test vaccine reached the non-inferiority criterion when compared with that of the control vaccine. All the lower limits of the 95%CI for positive transfer rates in the test group were>40%; all the lower limits of the 95%CI for positive rates were >70%, and all the GMI were>2.5, indicating the immunogenicity of the test vaccine reached the absolute standard. For safety, 30 days after 1 dose of vaccination, the incidence of adverse reactions in the test group and the control group aged 3 years and above were 10.67% (160 cases) and 11.21% (168 cases), respectively. The incidence of total adverse reactions were 6.29% (22 cases) and 10.86% (38 cases) in the subgroup aged 18-64, respectively (P<0.05). The main symptoms of adverse reactions included a pain at the vaccination site and fever, and the severity of adverse reactions were mainly at levels 1 and 2. There were no serious adverse reactions in the two groups.

Quadrivalent inactivated subunit influenza vaccine has a better immunogenicity and good safety in the application to people≥3 years.

This paper reports a case of endoscopic dissection of intratympanic facial nerve schwannoma without facial paralysis. A 59-year-old male was admitted to the hospital with "repeated pus discharge from both ears and hearing loss for more than ten years". CT of the temporal bone showed soft tissue foci in the right tympanic cavity, and MRI showed small soft tissue lesions in the middle ear tympanic cavity. T₁Weighted image (T₁WI) and other signals, T₂Weighted image (T₂WI) heterogeneous high signal, diffusion weighted image (DWI) partial high signal, no obvious enhancement after enhancement. He was diagnosed with "right chronic suppurative otitis media" and underwent right endoscopic tympanoplasty + ossicular chain reconstruction. The postoperative pathological diagnosis was facial nerve schwannoma.

A 57-year-old female patient diagnosed with advanced non-small cell lung cancer due to "repeated cough for 2 months" had previous programmed cell death ligand 1 (PD-L1) inhibitor combined with chemotherapy and programmed cell death receptor 1 (PD-1) inhibitor combined with radiotherapy. On September 17, 2020, he went to the Second Affiliated Hospital of Soochow University and enrolled in the "Bragg Therapy" clinical trial [Phase I/II clinical study of single-arm macrofractional radiotherapy combined with PD-1/PD-L1 inhibitor and granulocyte-macrophage colony stimulating factor (GM-CSF) immunotherapy for advanced multiple metastatic solid tumors]. After 6 cycles of macrofractional radiotherapy combined with PD-1 inhibitor and GM-CSF triple therapy, serum carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) levels decreased to the normal range, and the efficacy evaluation reached complete remission (CR). Followed by regular follow-up after 8 cycles of immune consolidation and maintenance therapy, the progression-free survival (PFS) reached 26 months.

Isolated distal deep vein thrombosis (IDDVT) is a thrombotic process involving only the deep veins of the lower leg, accounting for 30% to 50% of all lower limb deep vein thrombosis (DVT). Studies have shown that IDDVT has a potential risk of spreading to proximal deep veins and can cause pulmonary embolism (PE) in severe cases. In anticoagulant therapy, proximal DVT and PE have been deeply and extensively studied, and there is currently a set of standardized treatment protocols based on high-quality evidence. However, due to the different conclusions of existing clinical studies and the lack of high-quality randomized controlled trials, there is no consensus on the anticoagulant treatment strategy of IDDVT. This article focuses on whether anticoagulation, anticoagulant drug selection, anticoagulant dose selection and anticoagulant course selection after IDDVT.

Vaccination is one of the most economical and effective measures to prevent and control invasive Neisseria meningitidis (IMD). How to scientifically formulate immunization strategies that are compatible with the current epidemiological characteristics of IMD is the key factor affecting its prevention and control effect. Although the ACWY group tetravalent meningococcal polysaccharide conjugate vaccine (MenACWY/MCV4) launched in 2021 in my country has confirmed its immunogenicity and safety in clinical trials, it has not fully covered the high-risk population of IMD in practice, and there is a lack of long-term serological immune persistence data. In order to actively respond to the route plan to overcome meningitis by 2030 issued by WHO, this study summarized the application status of MCV4 vaccine in the world and the immunization strategies of various countries, and systematically analyzed the serological immune persistence data from the perspective of basic immunization and booster immunization. The results showed that the older the initial immunization age of MCV4 basic immunization, the better the serological immune persistence; Compared with groups W, Y, and C, anti-group A Neisseria meningitidis (Nm) The bactericidal activity of serum decayed the fastest. A booster dose of MCV4 3~6 years after basal immunization can induce long-lasting immune response and rapid immune memory. Given that adolescents are the highest incidence of IMD in China andNmFor groups with high carrier rate, the age range of MCV4 application in my country needs to be gradually expanded based on rigorous scientific clinical trial data, and the necessity of evaluating booster immunization strategies and corresponding implementation procedures should be explored.

The treatment strategies of facial schwannoma include surgery, radiotherapy and follow-up observation. There is no clear indication for these treatment methods at present, and there is no uniform conclusion on the treatment strategy of facial schwannoma. From the perspective of treatment modalities, the study retrospectively analyzed the relevant data of patients with facial nerve schwannoma from 1987 to 2018, including age, sex, clinical symptoms, tumor location, treatment strategy and treatment effect. A total of 22 patients underwent surgical treatment (including complete resection and subtotal resection), one underwent radiotherapy, and 22 were followed up without treatment. In patients who underwent total resection, no obvious signs of tumor recurrence were observed, and most patients complicated with grade 3 or 4 facial paralysis after surgery. Of the patients undergoing subtotal resection, facial nerve function remained unchanged in 4 patients compared with that before surgery, and facial nerve function deteriorated in 2 patients. Tumor recurrence was observed in 4 patients at postoperative follow-up, and 2 of them required reoperation. In the simple follow-up cases, 6 patients had enlarged tumor growth, 1 patient had aggravated facial paralysis, and 4 patients underwent facial nerve decompression due to facial paralysis. Therefore, surgical treatment is required when the tumor compresses the brain or grows faster. If the preoperative facial nerve function is ≤ grade 3, subtotal resection should be performed by considering preserving facial nerve function. When preoperative facial nerve function is ≥ grade 3, total tumor resection and nerve transplantation can be selected to prevent recurrence. If the tumor has no brain compression or tendency to grow rapidly, follow-up is a good choice, and decompression surgery should be considered for follow-up cases with facial paralysis.

High salt diet is closely related to the occurrence and development of common chronic diseases such as hypertension, stroke, heart disease, kidney disease and gastric cancer. In China, population salt intake mainly comes from salt added during home cooking, which is more than twice the adult limit recommended by the World Health Organization (WHO) (5 g/d); High salt intake is the third leading risk factor for death and disability, and the most important dietary risk factor. Salt reduction has been identified as one of the most cost-effective public health policies globally, but the effectiveness of salt reduction-related interventions has not been well-evaluated in randomized controlled trials (RCTs).

The standard treatment regimen for facial neuroma with normal or near normal facial nerve function [House-Brackmann (HB) grade I ~ II] is still controversial internationally. In order to achieve higher preservation of facial and hearing functions, therapeutic strategies and new therapies focusing on neurological preservation are being applied in the field of facial neuroma. This study is a retrospective study of low-fractionated stereotactic radiotherapy (hfSRS) in patients with facial nerve schwannoma (FNS). Four patients with intracranial FNS and one patient with extracranial FNS with preoperative facial nerve function of HBⅠ ~ Ⅱ from 2011 to 2019 were included in the study. The safety and efficacy of stereotactic radiotherapy were evaluated by a combination of tumor control, facial nerve function assessment (according to HB grading criteria) and auditory nerve function assessment (according to the recommendations of the American Academy of Otolaryngology and Head and Neck Surgery), and adverse radiation effects. The results showed that the median tumor volume of the patients in this study was 7.5 cm³(1.5~19.6 cm³), the median prescribed dose received was 23.2 Gy (21 to 25 Gy), and the median number of doses was 3 (3 to 5). The median follow-up was 31.4 months (13.0 to 71.0 months) for imaging and 32.6 months (15.1 to 72.0 months) for clinical symptoms. It was found that the local tumor control rate was 100.0%. At the last clinical follow-up, the facial nerve function of 4 patients (4/5) improved or remained unchanged in HB Ⅰ ~ Ⅱ, and the auditory nerve function of all patients improved or remained stable. Three (3/5) patients experienced transient clinical toxicity (facial nerve paralysis, earache, diplopia) and recovered within 6 weeks. None of the patients experienced adverse radiation reactions. Therefore, it is concluded that low-fractionation stereotactic radiotherapy appears to be safe and effective in the local tumor control of facial schwannoma and in the improvement of facial and auditory nerve function.