Reply:

I would like to thank Dr. Stasolla for his kind words in reference to my article, “The Many Faces of Facial Nerve Schwannoma.”¹ Although the “dural tail” sign has been reported with many pathologies, including acoustic schwannomas, none of the cases in my series demonstrated a dural tail on imaging. It is always difficult to interpret cases solely on the basis of a text description, but the case Dr. Stasolla describes in his letter is consistent with a facial nerve schwannoma. Both the clinical and imaging descriptions are consistent with the findings in my series, with a peripheral facial neuropathy in 10 cases (42%) and some type of hearing loss in 11 cases (46%), and for the radiologic description (benign osseous remodeling on CT and enhancing lesion along the course of the facial nerve on MR imaging).

I agree with Dr. Stasolla that there are a variety of etiologies that can lead to a dural tail sign in MR imaging, and I would be happy to review his case because I am always interested in seeing good head and neck cases.

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