Victoria Hospital, Kirkcaldy, Fife, UK.
Ann R Coll Surg Engl. 2021 Jan;103(1):47-52. doi: 10.1308/rcsann.2020.0194. Epub 2020 Sep 24.
Parotid masses causing facial palsy are highly indicative of malignancy. A significant number of cases describing benign parotid disease causing facial palsy have been reported.
We performed a systematic review of the literature to establish the aetiology, clinical features, investigations and management undertaken during these presentations to assess how these factors differed from malignant presentations and to establish an evidence-based algorithm for their management.
A total of 85 cases were identified from 78 articles. Cystadenolymphomas were the most common histopathological type ( = 0.034). Mean facial palsy recovery duration in neoplastic aetiology was longer than for infective aetiology ( = 0.033). A significant association existed between uncommon infective organisms and development of facial palsy ( = <0.0001).
Uncommon benign aetiologies are associated with facial palsy. Investigations and management should be guided by patients' clinical presentations, avoiding excessive treatment. Complete facial palsy recovery rates are high, although not immediate.
导致面瘫的腮腺肿块高度提示为恶性肿瘤。已有大量描述良性腮腺疾病导致面瘫的病例报告。
我们对文献进行了系统回顾,以确定这些病例的病因、临床特征、检查和治疗方法,评估这些因素与恶性表现的差异,并为其治疗制定基于证据的算法。
从 78 篇文章中总共确定了 85 例病例。囊性腺淋巴瘤是最常见的组织病理学类型(=0.034)。肿瘤病因引起的面瘫恢复时间长于感染性病因(=0.033)。不常见的感染性病原体与面瘫的发生之间存在显著关联(=<0.0001)。
不常见的良性病因与面瘫有关。检查和治疗应根据患者的临床表现进行指导,避免过度治疗。完全恢复面瘫的比例很高,尽管不是立即恢复。