• To review the normal imaging anatomy of facial nerve. • To illustrate the different images presentations of facial nerve schwannomas and their most frequents differential diagnosis.

Background: Correctly identifying facial nerve pathology requires a detailed understanding of the complex facial nerve normal anatomy. Facial nerve anatomy consists of 8 segments: intra-axial, cisternal, intracanalicular, labyrinthine, geniculate ganglion, intratympanic, intramastoid and extracranial. Intra-axial segment The intra-axial segment of the facial nerve, located in the pons, consists of the motor nucleus of cranial nerve (CN) VII, solitarius tract nucleus (sensory), and superior salivary nucleus (parasympathetic). Efferent motor fibers arise from the motor nucleus within the ventrolateral pontine tegmentum. These fibers initially course dorsally, loop...

Facial nerve schwannomas (FNS), although rare, is the most frequent tumor of the facial nerve. They can arise anywhere along the course of the facial nerve, from its origin in the cerebellopontine angle to its extracranial ramifications in the parotid space. The geniculate ganglion is the segment most frequently affected. Schwannomas in any location in the human body characteristically demonstrate homogeneously or heterogeneously enhancing soft tissue attenuation that is isoattenuated to gray matter on contrast-enhanced CT and may contain cystic foci. FNSs are classically described...

The facial nerve schwannoma image may vary according to its topography, and it is essential that the radiologist recognize these different presentations. The anatomical knowledge helps in the differential diagnosis with surrounding structures. There are signs suggestive of origin in the facial nerve, such as tail, dumbbells, honeycomb, beak and target.

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