Parapharyngeal Schwannoma of the Mandibular Nerve Associated With Auditory Changes

We present a case of a parapharyngeal schwannoma of the mandibular nerve with intraosseous extension into the mandible. The initial symptoms included decreased auditory acuity, with subsequent magnetic resonance imaging findings suggestive of Eustachian tube obstruction. This represents a rare symptom of schwannomas of the mandibular nerve. Owing to the degree of bony expansion and cortical thinning of the adjacent mandibular ramus, concern existed for a pathologic fracture. Treatment involved complete excision of the lesion using hemimandibulectomy with second stage reconstruction. The patient noted resolution of the preoperative symptoms. No sign of recurrence of the schwannoma was noted at the 2-year mark.