华西口腔医学杂志

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腮腺内面神经鞘瘤的诊断与治疗

刘仔龙  张国志   

  1. 暨南大学第二临床医学院深圳市人民医院口腔颌面外科,深圳 518020
  • 出版日期:2015-08-01 发布日期:2015-08-01
  • 通讯作者: 张国志,教授,硕士,E-mail:szzgz@aliyun.com
  • 作者简介:刘仔龙,住院医师,硕士,E-mail:290829747@qq.com

Diagnosis and management of intraparotid facial nerve schwannoma

Liu Zilong, Zhang Guozhi   

  1. Dept. of Oral and Maxillofacial Surgery, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen 518020, China
  • Online:2015-08-01 Published:2015-08-01

摘要:

腮腺内面神经鞘瘤(IFNS)较为罕见,术前诊断困难,多在手术中得以发现,其治疗极具挑战性。本文复习了1958—2014年PubMed收录的IFNS相关文献,详细介绍了IFNS的临床表现、诊断与鉴别诊断以及治疗方法的选择。IFNS主要依赖术中诊断和术后组织学检查,对其治疗必须参考患者术前的面神经功能,肿瘤与面神经的关系,以及患者的主观要求;对于面神经功能为House-Brackmann分级为3级以上的患者可选择手术治疗,否则宜选择保守治疗。

关键词: 腮腺内面神经鞘瘤, 面神经, 腮腺

Abstract:

Intraparotid facial nerve schwannoma (IFNS) is a rare benign tumor. The management of IFNS is very challenging because of the lack of appropriate methods for preoperative diagnosis, which is often conducted intraoperatively in most cases. This article reviewed the literature on IFNS recorded in PubMed from 1958 to 2014 and described in detail its clinical manifestations, diagnoses and differential diagnoses, and treatment options. Accurate diagnosis for IFNS mainly depends on intraoperative observation and postoperative histological examination. Preoperative facial nerve function, localization, and adherence, as well as preferences of IFNS patients are important factors to consider in the decision-making process for IFNS management to optimize the outcomes. Surgical resection is usually reserved for patients with facial function of House-Brackmann grade Ⅲ or worse; otherwise, conservative treatment can be adopted.

Key words: intraparotid facial nerve schwannoma, facial nerve, parotid gland