Department of Otolaryngology/HNS, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA.
Department of Pathology, Louisiana State University, Shreveport, Louisiana, USA.
BMJ Case Rep. 2020 Dec 9;13(12):e237537. doi: 10.1136/bcr-2020-237537.
This report describes the diagnosis and treatment of a patient with a rare primary facial nerve paraganglioma as well as a review of the current literature. A 60-year-old male patient presented to our clinic with a 4-month history of left-sided progressive facial paralysis House-Brackmann V. Biopsy taken during facial nerve (FN) decompression confirmed the diagnosis of paraganglioma. The left FN was sacrificed during resection of the mass and a 12-7 jump graft, using the left greater auricular nerve, was performed with acceptable outcomes. The rarity of these tumours does not discount their clinical importance or the necessity to include them in the differential when presented with unilateral FN paralysis. Investigation should begin with CT and MRI imaging to identify and localise the potential mass. Histologic confirmation requires tissue. While surveillance imaging is occasionally an option, often complete surgical resection of the mass and sacrifice of the nerve is necessary.
本报告描述了一例罕见的原发性面神经副神经节瘤的诊断和治疗,并对当前文献进行了回顾。一名 60 岁男性患者因左侧进行性面瘫 House-Brackmann V 型就诊于我院。面神经减压术中的活检证实了副神经节瘤的诊断。由于肿瘤切除,左侧面神经被牺牲,并采用左侧耳大神经进行了 12-7 跳跃移植,结果可接受。这些肿瘤的罕见性并不排除它们的临床重要性,也不应在单侧面神经麻痹时排除它们的鉴别诊断。检查应从 CT 和 MRI 成像开始,以识别和定位潜在的肿块。组织学确认需要组织。虽然有时可以选择监测成像,但通常需要完全切除肿块并牺牲神经。