Rigante M, Petrelli L, DE Corso E, Paludetti G
Department of Head and Neck Surgery, Institute of Otorhinolaryngology; Catholic University of Medicine and Surgery, Rome, Italy.
Acta Otorhinolaryngol Ital. 2015 Feb;35(1):49-52.
We report a rare case of a large intraparotid facial nerve schwannoma (IFNS) in a 51-year-old female who presented with a painless, slow growing left parotid mass without peripheral facial nerve palsy, with non-specific findings at preoperative diagnostic work-up, that was treated with conservative surgery. Management of IFNS is very challenging because the diagnosis is often made intra-operatively, and in most cases resection may lead to severe facial nerve paralysis, with important aesthetic sequelae. Our experience suggests a new surgical option, namely intra-capsular enucleation using a microscope, currently used for schwannomas arising from a major peripheral nerve, which should be a safe and reliable treatment for IFNS. This surgical technique is the first experience of intracapsular microenucleation of facial nerve schwannoma described in the literature and allows preservation of the nerve without resection and reconstruction.
我们报告了一例罕见的腮腺内面神经鞘瘤（IFNS），患者为一名51岁女性，表现为左侧腮腺有无痛、生长缓慢的肿块，无周围面神经麻痹，术前诊断检查结果无特异性，接受了保守手术治疗。IFNS的治疗极具挑战性，因为诊断往往在术中做出，而且在大多数情况下，切除可能导致严重的面神经麻痹，并伴有严重的美学后遗症。我们的经验提出了一种新的手术选择，即使用显微镜进行囊内摘除术，目前该方法用于治疗主要周围神经产生的神经鞘瘤，对于IFNS来说应该是一种安全可靠的治疗方法。这种手术技术是文献中描述的面神经鞘瘤囊内微摘除术的首例经验，可在不进行神经切除和重建的情况下保留神经。
