Intraparotid Facial Nerve Schwannoma: Diagnosis and Management

Otolaryngology - Head and Neck Surgery - Tập 130 - Trang 586-592 - 2004
Robert J Caughey1, Mark May1, Barry M Schaitkin1
1Department of Otolaryngology–Head and Neck Surgery, Shadyside Hospital Facial Paralysis Center, Pittsburgh, PA, USA

Tóm tắt

OBJECTIVEFacial nerve schwannomas are rare neoplasms that present a challenge in diagnosis and management. We sought to gain insight into the clinical presentation and its implications in management.STUDY DESIGN AND SETTINGA group of patients diagnosed with schwannoma was reviewed, with focus on tumor arising in the intraparotid region of the facial nerve. The patient population consisted of 3722 patients evaluated retrospectively over 38 years at the Shadyside Facial Paralysis Center, a tertiary referral center. From this population, 29 patients (18 women and 11 men) with the diagnosis of schwannoma were selected for review.RESULTSTwenty‐nine patients had facial nerve schwannoma. The average age at diagnosis was 44 years (range, 7 to 78 years). Eight patients had intraparotid involvement, with 5 having a palpable mass in the parotid. The duration of symptoms averaged 8.4 years overall, with intraparotid involvement averaging 10.9 years. The 8 intraparotid schwannomas had a mean House‐Brackmann grade of 1.5/6 at initial presentation. Postoperative facial nerve function was only 4.4/6 for resected intraparotid schwannomas.CONCLUSIONSIntraparotid facial nerve schwannomas are slow growing tumors, which are usually asymptomatic but can be painful. Schwannoma should be suspected if the facial nerve cannot be found intraoperatively or if the tumor is intimately associated with the facial nerve. In cases where schwannoma is suspected, biopsy is recommended, while complete resection is postponed to obtain imaging studies to evaluate the extent of disease and to discuss possible outcomes with the patient.SIGNIFICANCEThis article provides guidance for the appropriate management of intraparotid facial nerve schwannoma.

Tài liệu tham khảo

Walter JB, 1979, General Pathology, 319 10.1288/00005537-196408000-00002 10.1017/S0022215100134474 O'Donoghue GM, 1989, Neuromas of the facial nerve., Am J Otol, 10, 49 10.1177/019459988709600113 Elahi MM, 1995, Intraparotid facial nerve schwannoma., J Otolaryngol, 24, 364 10.1055/s-2008-1056979 10.1016/S0194-59989770084-6 10.1177/019459989310800111 10.3109/00016488309130957 10.1001/archotol.1969.00770030744017 Chen JM, 1995, Magnetic resonance imaging and intraoperative frozen sections in intratemporal facial schwannomas., Am J Otolaryngol, 16, 68 10.3349/ymj.1998.39.2.148 Barnes L, 1985, Surgical pathology of the head and neck, 662 10.1046/j.1440-1622.2000.01941.x 10.1017/S0022215100145657 10.1288/00005537-197202000-00006 10.1001/archsurg.1971.01350070077018 10.1017/S0022215100073011 O'Donoghue GM, 1994, Neurotology, 1328 Pillsbury HC, 1983, Primary tumors of the facial nerve: diagnosis and management., Laryngoscope, 83, 1045, 10.1288/00005537-198308000-00014 May M, 2000, The facial nerve, May's, 571
Thông tin
Thông tin xuất bản

Otolaryngology - Head and Neck Surgery

Tập 130

586-592

Thông tin tác giả