Vellin J-F, Mom T, Kemeny J-L, Essamet W, Gilain L
Service d'ORL, Centre Hospitalier Universitaire, BP 69, 63003 Clermont-Ferrand Cedex 1.
Ann Otolaryngol Chir Cervicofac. 2003 Sep;120(4):231-6.
We describe a case of intraparotid facial nerve schwannoma. About sixty patients with intraparotid tumors have been reported in the literature.
A 89-year-old female patient presented with a history of progressive facial palsy and a left intraparotid mass. The mass was removed by parotidectomy for definitive diagnosis and treatment. We reviewed the findings in comparison with data in the literature.
The well-encapsulated tumor arose from the superior branch of the intraparotid facial nerve. As the tumor could not be dissected from the nerve, a segment of facial nerve was sacrificed and repaired by interposing a greater auricular nerve. The final pathological diagnosis was schwannoma arising from the facial nerve.
This case illustrates the clinical and pathologic features of intraparatid facial nerve schwannoma and points out the pitfalls of diagnosis and treatment. Consensus has recognized total resection surgery with facial nerve sacrifice as the most reasonable treatment for these tumors. We discuss the currently accepted management approach as well as the different treatment modalities for recovering facial function.
我们描述一例腮腺内面神经鞘瘤病例。文献中已报道约60例腮腺内肿瘤患者。
一名89岁女性患者，有进行性面神经麻痹病史及左侧腮腺内肿块。通过腮腺切除术切除肿块以明确诊断和治疗。我们将检查结果与文献数据进行了比较。
包膜完整的肿瘤起源于腮腺内面神经的上支。由于肿瘤无法从神经上剥离，故牺牲一段面神经，并通过植入耳大神经进行修复。最终病理诊断为起源于面神经的鞘瘤。
本病例说明了腮腺内面神经鞘瘤的临床和病理特征，并指出了诊断和治疗中的陷阱。共识认为，牺牲面神经的全切除手术是这些肿瘤最合理的治疗方法。我们讨论了目前公认的治疗方法以及恢复面部功能的不同治疗方式。
