Samson M J, Metson R, Wang C C, Montgomery W W
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston.
Laryngoscope. 1991 Oct;101(10):1060-2. doi: 10.1288/00005537-199110000-00006.
Whether to preserve or sacrifice a facial nerve involved with benign neoplasm is one of the most difficult intraoperative decisions confronting the head and neck surgeon. We reviewed 21 cases of recurrent pleomorphic adenoma treated with subtotal excision and facial nerve preservation, followed by postoperative radiation therapy. Of the 17 patients with microscopic residual tumor at completion of surgery, 16 (94%) remain free of recurrence with an average follow-up of 5.9 years. Only one of four patients (25%) with a large postoperative tumor load remains free of disease. Facial nerve function is normal in 20 of 21 patients. Preservation of the facial nerve with postoperative irradiation should be considered as an alternative to nerve sacrifice in selected cases of recurrent pleomorphic adenoma.
对于涉及良性肿瘤的面神经，是予以保留还是牺牲，这是头颈外科医生在术中面临的最困难的决策之一。我们回顾了21例采用次全切除加面神经保留术治疗的复发性多形性腺瘤病例，术后均接受放射治疗。手术结束时，17例有镜下残留肿瘤的患者中，16例（94%）在平均5.9年的随访期内无复发。术后肿瘤负荷大的4例患者中，只有1例（25%）无疾病复发。21例患者中有20例面神经功能正常。对于某些复发性多形性腺瘤病例，保留面神经并术后放疗应被视为一种替代牺牲神经的选择。
