Li Yang, Liu Hui, Cheng Yan
Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Medical School of Xi'an Jiao Tong University , Xi'an, 710004 , PRC.
Acta Otolaryngol. 2014 Apr;134(4):433-6. doi: 10.3109/00016489.2013.871746. Epub 2014 Feb 4.
Subtotal resection of facial nerve schwannoma (FNS) could obtain favorable facial nerve function recovery, but has a high recurrence rate in the long run. Subtotal resection with about 95% tumor resected could be considered in the elderly with good facial nerve function, but is not recommended for younger patients. Subtotal resection with about 70-80% tumor resected should be replaced by complete tumor removal and nerve grafting.
To present long-term follow-up results of subtotal resection of FNS and discuss the indications for subtotal resection.
We performed subtotal resection of FNS in 15 cases and they were followed up for 7 years on average.
In all, 93.3% of cases finally gained normal or near-normal facial nerve function (House-Brackmann (HB) grade I or II) and one case maintained grade III. Tumor recurrence or regrowth was noted in four cases (26.7%) during follow-up. Recurrence was observed in 10% of cases who had about 95% tumor resected and in 60% of cases who had 70-80% tumor resected.
面神经鞘瘤（FNS）次全切除可获得较好的面神经功能恢复，但长期来看复发率较高。对于面神经功能良好的老年患者，可考虑行肿瘤切除约95%的次全切除，但不推荐用于年轻患者。肿瘤切除约70 - 80%的次全切除应被肿瘤全切并神经移植所取代。
呈现FNS次全切除的长期随访结果并讨论次全切除的适应证。
我们对15例患者进行了FNS次全切除，平均随访7年。
总体而言，93.3%的患者最终获得了正常或接近正常的面神经功能（House-Brackmann（HB）分级I或II级），1例维持在III级。随访期间4例（26.7%）出现肿瘤复发或再生长。肿瘤切除约95%的患者中10%出现复发，肿瘤切除70 - 80%的患者中60%出现复发。
