Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

FACIAL NERVE SCHWANNOMA IN PAROTID GLAND: A CASE REPORT

이하선에 발생한 안면신경 신경초종의 치험례

  • Choi, Se-Kyung (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Choi, Jong-Myung (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Kim, Hyun-Sil (Oral Cancer Research Institute, College of Dentistry, Yonsei University) ;
  • Kim, Hyung-Jun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Cha, In-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Nam, Woong (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • 최세경 (연세대학교 치과대학병원 구강악안면외과) ;
  • 최종명 (연세대학교 치과대학병원 구강악안면외과) ;
  • 김현실 (연세대학교 치과대학병원 구강종양연구소) ;
  • 김형준 (연세대학교 치과대학병원 구강악안면외과) ;
  • 차인호 (연세대학교 치과대학병원 구강악안면외과) ;
  • 남웅 (연세대학교 치과대학병원 구강악안면외과)
  • Received : 2009.09.21
  • Accepted : 2010.01.12
  • Published : 2010.01.29
Download PDF
⟨ Previous Next ⟩

Abstract

Facial nerve schwannomas (FNSs) are usually painless, slow-growing, and without specific symptoms, so that early diagnosis may be difficult. They are particularly liable to being misdiagnosed as parotid gland origin benign tumor before surgery, which can lead to unnecessary parotidectomy or unexpected facial nerve injury. To prevent these complications, it is important that the correct diagnosis is performed at least in intraoperative time. When an adhesion between the mass and the facial nerve is exist or when electrical stimulation of the mass triggers facial movement, FNS is highly suggested diagnosis. In such cases, frozen section analysis should always be performed. In this case, the pre-operative diagnosis from clinical examination and MRI was pleomorphic adenoma. However, intraoperative features led us to suspect that the mass originated from facial nerves, and intraoperative frozen section analysis yielded results consistent with a schwannoma. Based on this intraoperative diagnosis, we carried out a successful conservative treatment with preservation of facial nerve.

Keywords

References

  1. Kreeft A, Schellekens PP, Leverstein H : Intraparotid facial nerve schwannoma. What to do? Clin Otolaryngol 32: 125, 2007, https://doi.org/10.1111/j.1365-2273.2007.01352.x
  2. KW Chong, YF Chung, ML Khoo et al : Management of intraparotid facial nerve schwannomas. Aust N Z J Surg 70: 732, 2000. https://doi.org/10.1046/j.1440-1622.2000.01941.x
  3. Marchioni D, Alicandri Ciufelli M, Presutti L : Intraparotid facial nerve schwannoma: literature review and classification proposal. J Laryngol Otol 121: 707, 2007.
  4. Ulku CH, Uyar Y, Acar O et al : Facial nerve schwannomas: a report of four cases and a review of the literature. Am J Otolaryngol 25: 426, 2004. https://doi.org/10.1016/j.amjoto.2004.04.013
  5. Mehta RP, Deschler DG : Intraoperative diagnosis of facial nerve schwannoma at parotidectomy. Am J Otolaryngol 29: 126, 2008. https://doi.org/10.1016/j.amjoto.2007.03.001
  6. House JW : Facial nerve grading systems. Laryngoscope 93: 1056, 1983.
  7. Caughey RJ, May M, Schaitkin BM : Intraparotid facial nerve schwannoma: diagnosis and management. Otolaryngol Head Neck Surg 130: 586, 2004. https://doi.org/10.1016/j.otohns.2003.12.011
  8. Lipkin AF, Coker NJ, Jenkins HA, et al : Intracranial and intratemporal facial neuroma. Otolaryngol Head Neck Surg 96: 71, 1987. https://doi.org/10.1177/019459988709600113
  9. Saleh E, Achilli V, Naguib M et al : Facial nerve neuromas: diagnosis and management. Am J Otol 16: 521, 1995.
  10. King TT, Morrison AW : Primary facial nerve tumors within the skull. J Neurosurg 72: 1, 1990. https://doi.org/10.3171/jns.1990.72.1.0001
  11. JC Kim, Bhattacharjee M, Amedee RG : Facial nerve schwannoma. Ann Otol Rhinol Laryngol 112: 185, 2003. https://doi.org/10.1177/000348940311200214
  12. Mutlu C, Djeric DR, Tekin M et al : Facial neuroma in the internal auditory canal. Auris Nasus Larynx 27: 175, 2000. https://doi.org/10.1016/S0385-8146(99)00050-4
  13. Salemis NS, Karameris A, Gourgiotis S et al : Large intraparotid facial nerve schwannoma: case report and review of the literature. Int J Oral Maxillofac Surg 37: 679, 2008. https://doi.org/10.1016/j.ijom.2008.01.018
  14. Alphs HH. Eisele DW, Westra WH : The role of fine needle aspiration in the evaluation of parotid masses. Curr Opin Otolaryngol Head Neck Surg 14: 62, 2006. https://doi.org/10.1097/01.moo.0000193184.38310.0a
  15. Alicandri-Ciufelli M, Marchioni D, Mattioli F et al : Critical literature review on the management of intraparotid facial nerve schwannoma and proposed decisionmaking algorithm. Eur Arch Otorhinolaryngol 266: 475, 2009. https://doi.org/10.1007/s00405-008-0893-4
  16. May M, Schaitkin BM : The facial nerve, May's 2nd ed. ed. New York, Thieme, 2000, p.571.
  17. Neville BW : Oral and maxillofacial pathology, 3rd ed. ed. Edinburgh, Saunders, 2009, p.526.
  18. Hasan NU, Kazi T : Malignant schwannoma of facial nerve. J Pediatr Surg 21: 926, 1986. https://doi.org/10.1016/S0022-3468(86)80090-2
  19. Conley J, Janecka I : Neurilemmoma of the facial nerve. Plast Reconstr Surg 52: 55, 1973. https://doi.org/10.1097/00006534-197307000-00010