Lekhbal Adil, Lyoubi Hicham, Wydadi Omar, Bouzbouz Anas, Abada Reda Lah, Rouadi Sami, Roubal Mohamed, Mahtar Mohamed
ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco.
Ann Med Surg (Lond). 2020 May 8;55:9-12. doi: 10.1016/j.amsu.2020.04.022. eCollection 2020 Jul.
Intraparotid facial nerve neurofibromas are benign neoplasms, extremely rare, difficult to diagnose and to manage. Only three pediatric cases have been reported in the literature.
We report the 4th case of a 7-year-old child admitted for a parotid mass without facial palsy, for whom the surgical indication was the increase in volume of this mass, as well as the aesthetical impairment, the surgical exploration found the tumor attached to the lower branch of the division of the facial nerve. The excision of the mass was performed with the sacrifice of the inferior branch of the facial nerve, the trunk and the upper branch of the facial nerve was preserved, the pathological study was in favor of a plexiform neurofibroma.The patient has presented postoperatively a grade 5 facial palsy in the inferior territory of the facial nerve with a slight recovery 1 year after surgery.
Even though plexiform neurofibromas in the parotid gland are extremely rare, and their diagnosis are not often primary evoked in front of any growing mass of this region, the surgeon must keep in mind the existence of these neoplasms as a differential diagnosis of a parotid tumor.
腮腺内面神经神经纤维瘤是良性肿瘤，极为罕见，诊断和处理都很困难。文献中仅报道过3例儿科病例。
我们报告第4例病例，一名7岁儿童因腮腺肿物入院，无面瘫症状，手术指征是肿物体积增大以及美观受损。手术探查发现肿瘤附着于面神经分支的下支。切除肿物时牺牲了面神经下支，保留了面神经主干和上支，病理研究结果支持丛状神经纤维瘤的诊断。患者术后面神经支配区域下部出现5级面瘫，术后1年略有恢复。
尽管腮腺内丛状神经纤维瘤极为罕见，而且在该区域出现任何肿物时通常都不会首先考虑其诊断，但外科医生必须牢记这些肿瘤的存在，将其作为腮腺肿瘤的鉴别诊断之一。
