Lee Jong Dae, Kim Sung Huhn, Song Mee Hyun, Lee Ho-Ki, Lee Won-Sang
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
Laryngoscope. 2007 Jun;117(6):1063-8. doi: 10.1097/MLG.0b013e31804b1a51.
We report six cases of facial nerve schwannomas in which surgical management allowed the preservation of facial nerve function. Specifically, this paper reports that a stripping surgery may provide favorable functional outcomes.
A retrospective review of preoperative and postoperative data for six patients with facial nerve schwannoma that had normal facial nerve function or a House-Brackmann grade II facial palsy before the surgery.
Stripping surgery, which removed the schwannoma from the remaining nerve fascicle, was attempted on the six patients. Postoperative facial nerve function and imaging (magnetic resonance imaging) were evaluated.
Stripping surgery with gross total tumor removal of the mass was performed in four cases. In the two remaining cases, the stripping surgery was not possible, and decompression alone was performed. Favorable preservation of facial function was achieved in all six cases.
It was possible to preserve facial function after surgery to remove facial nerve schwannoma. We suggest that stripping surgery, focused on the preservation of continuity of the facial nerve, may be attempted for facial nerve schwannoma in which favorable facial function has been preserved.
我们报告6例面神经鞘瘤病例,其手术治疗保留了面神经功能。具体而言,本文报告了一种剥离手术可能带来良好的功能预后。
回顾性分析6例面神经鞘瘤患者术前和术后的数据,这些患者在手术前面神经功能正常或为House-Brackmann II级面瘫。
对这6例患者尝试进行剥离手术,即从剩余神经束上切除神经鞘瘤。评估术后面神经功能和影像学检查(磁共振成像)结果。
4例患者进行了剥离手术并实现了肿瘤的全切除。其余2例无法进行剥离手术,仅实施了减压手术。所有6例患者均实现了面神经功能的良好保留。
切除面神经鞘瘤手术后有可能保留面神经功能。我们建议,对于术前面神经功能良好的面神经鞘瘤,可尝试进行以保留面神经连续性为重点的剥离手术。