PMC5697583_01
(a) Magnetic resonance imaging showing a 20 mm x 46 mm well-circumscribed mass lesion (yellow arrow) and (b) computed tomography showing well-circumscribed mass lesion in the left external auditory canal, tympanic cavity and mastoid air cells (yellow arrow), blue arrow shows facial nerve.
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Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-circumscribed mass lesion in the left EAC, tympanic cavity and mastoid air cells with the invasion into the parotid gland (Figure 1).
(a) A super-thin, free anterolateral thigh pure skin perforator flap was elevated from the left thigh region. (b) The flap was rolled up as a sac: yellow arrow: nerve, red arrow: pedicle, blue arrow: skin flap and (c) intraoperative appearance after the resection of left facial nerve schwannoma.
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After resection and tympanoplasty, the vascularized LFCN with an 8 cm x 2 cm, super-thin, free ALT full-thickness skin flap was elevated from the left thigh region (Figure 2(a) and (c)). The flap was then rolled up as a sac (diameter of 2 cm, height of 2 cm) and inset to the EAC defect (Figure 2(b)).
Otoscope showing completely survived anterolateral thigh (ALT) flap at the osseous potion of auditory canal: blue arrow: tympanum, green arrow: ALT flap.
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The postoperative course was uneventful, and the flap survived completely (Figure 3).
The facial appearance 21 months after the surgery.
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Synkinesis and contracture were also improved (Figure 4).