Abstract:
Facial nerve schwannomas are rare, benign, slow-growing tumors that can occur in any segment of the facial nerve, although 71% of cases are intratemporal. Surgical resection can lead to facial nerve injury. Facial function recovery after reanimation is usually not better than House-Brackmann (HB) grade III. Thus, for cases of intratemporal facial nerve schwannomas (IFNSs) with favorable facial function (HB grade I or II), observation by periodic magnetic resonance imaging is the mainstay of management. Here, we present a case of a large IFNS with normal facial function in which the mass fully occluded the external auditory canal. The occlusion caused squamous debris to accumulate, potentially leading to cholesteatoma. Faced with this therapeutic dilemma, we chose surgical resection with the patient\'s informed consent. Stripping surgery was achieved with normal postoperative facial function. There was no postoperative facial paralysis or recurrence at 2-year follow-up. We describe the experience of diagnosis and treatment process for this case, and discuss the possibility of total resection of the tumor with preserving the integrity of facial nerve.
摘要:
面神经神经鞘瘤很少见,良性,缓慢生长的肿瘤,可以发生在面神经的任何部分,尽管71%的病例是颞内。手术切除可导致面神经损伤。复活后的面部功能恢复通常不比House-Brackmann(HB)III级更好。因此,对于具有良好面部功能(HBI级或II级)的颞内面神经神经鞘瘤(IFNSs)的病例,定期磁共振成像观察是管理的主要手段。这里,我们介绍了一个具有正常面部功能的大型IFNS病例,其中肿块完全阻塞了外耳道。闭塞导致鳞状碎片积聚,可能导致胆脂瘤.面对这种治疗困境,我们在患者知情同意的情况下选择手术切除。剥离术后面部功能正常。随访2年无术后面瘫或复发。我们描述了这种情况的诊断和治疗过程的经验,并讨论保留面神经完整性的肿瘤全切除的可能性。