Liu Liangfa, Yang Shiming, Han Dongyi, Yang Weiyan
Department of Otorhinolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2002 Oct;37(5):352-5.
To summarize the clinic characteristics of the tumors of facial nerve and discuss the diagnosis and treatment.
Fourteen cases of primary facial nerve tumors confirmed pathologically and treated in the Chinese PLA General Hospital from 1986-2000 were reviewed. The clinic manifestation, diagnosis and treatment in this series were analyzed.
Among the 14 cases, there were 9 of facial neurilemmoma, 3 of facial neurofibroma and 2 of facial nerve hemangioma. The commonest first symptom was facial paralysis (10/14), the next was hearing loss(6/10). The commonest sign was the facial paralysis. The following was tumor in tympanic cavity (5/14) and the next was tumor in external auditory canal(4/14). The tumors in all 14 cases were totally resected surgically. The function of the facial nerve was normal in one case with nerve being preserved intact during operation, and in grade II in one case and grade III in other one case with nerves being preserved partly continuous. Facial--great auricular-facial nerve cable grafting were done in 6 cases, as result their facial nerve were in grade II in 2 cases, grade III in 3 case and grade IV in 1 case. The facial-lateral femoral cutaneous-facial nerve cable grafting was done in one case, and the facial nerve function was in grade III with 6 years of following-up. The second-stage facial-hypoglossal nerve anastomosis was done in one case, and the facial function consequently recover to grade II with 3 years of following-up. Three cases of facial nerve remained discontinuity and their facial nerve function showed no recovery (in grade VI).
Once the facial nerve tumors were diagnosed, the surgical treatment should be done as early as possible. At the same time of tumor resection, the continuity of facial nerve should be kept and reconstructed in one stage as possible as we can, otherwise the second-stage surgery have be conducted soon after.
总结面神经肿瘤的临床特点，探讨其诊断与治疗方法。
回顾性分析1986年至2000年在中国人民解放军总医院经病理确诊并接受治疗的14例原发性面神经肿瘤患者的临床资料，分析其临床表现、诊断及治疗情况。
14例患者中，面神经鞘瘤9例，面神经纤维瘤3例，面神经血管瘤2例。最常见的首发症状为面瘫（10/14），其次为听力下降（6/10）。最常见的体征为面瘫，其次为鼓室肿瘤（5/14），外耳道肿瘤（4/14）。14例患者均行手术全切肿瘤。术中1例面神经完整保留，术后面神经功能正常；1例面神经部分连续性保留，术后面神经功能Ⅱ级；1例面神经部分连续性保留，术后面神经功能Ⅲ级。6例行面-耳大-面神经电缆移植术，术后2例面神经功能Ⅱ级，3例Ⅲ级，1例Ⅳ级。1例行面-股外侧皮-面神经电缆移植术，随访6年，面神经功能Ⅲ级。1例行二期面-舌下神经吻合术，随访3年，面神经功能恢复至Ⅱ级。3例面神经连续性中断，面神经功能无恢复（Ⅵ级）。
面神经肿瘤一旦确诊，应尽早手术治疗。手术切除肿瘤的同时，应尽可能一期保留并重建面神经的连续性，否则应尽早行二期手术。
