Kempf H G, Steinbach E
Hals-Nasen-Ohren-Klinik, Universität, Tübingen.
HNO. 1989 Jan;37(1):14-8.
Nine facial nerve schwannomas were observed in more than 1,350 operations on the parotid gland. Eight patients had a pre-operative diagnosis of pleomorphic adenoma without facial palsy. One patient who underwent extensive surgery without preservation of the facial nerve for a tumour present for more than 10 years had a pre-operative facial palsy. Facial nerve function recovered totally or partially in six peripheral schwannomas. In two cases with main trunk schwannoma no reinnervation was observed despite end-to-end anastomosis or interposition of the great auricular nerve. Histology showed eight typical schwannomas and one neurofibroma. Neurofibromas are extremely rare in the parotid gland. Clinical and operative experience with parotid gland schwannomas shows that recovery of facial nerve defects is mostly incomplete. Reconstructive methods should be used, but the long-term prognosis is uncertain.
在超过1350例腮腺手术中观察到9例面神经鞘瘤。8例患者术前诊断为多形性腺瘤，无面神经麻痹。1例因肿瘤存在超过10年而接受未保留面神经的广泛手术的患者术前存在面神经麻痹。6例周围性神经鞘瘤的面神经功能完全或部分恢复。在2例主干神经鞘瘤病例中，尽管进行了端端吻合或耳大神经移植，仍未观察到神经再支配。组织学显示8例典型神经鞘瘤和1例神经纤维瘤。神经纤维瘤在腮腺中极为罕见。腮腺神经鞘瘤的临床和手术经验表明，面神经缺损的恢复大多不完全。应采用重建方法，但长期预后不确定。
