中国耳鼻咽喉颅底外科杂志2025，Vol.31Issue(5)：81-85,5.DOI:10.11798/j.issn.1007-1520.202525062
面神经瘤的临床诊治分析
Analysis on clinical diagnosis and treatment of facial neuroma
陈乌娜 1林勤 1关丽梅 1苏文玲1
作者信息
- 1. 厦门大学附属第一医院耳鼻咽喉头颈外科福建医科大学第三临床医学院厦门市耳鼻咽喉头颈外科重点实验室,福建厦门 361003
- 折叠
摘要
Abstract
Objective To analyze and discuss the clinical diagnosis and treatment strategies for facial neuroma,enhance understanding of the disease,and avoid misdiagnosis and mismanagement.Methods Clinical data of 8 patients with facial neuroma treated in our department from September 2012 to December 2022 were collected and retrospectively analyzed.Facial nerve function was evaluated using the House-Brackmann(H-B)system.Results Among the 8 patients,3 had a history of peripheral facial paralysis,and 7 presented with parotid gland masses.The 3 patients with facial paralysis were correctly diagnosed with facial neuroma before operation,while the 5 cases without any facial paralysis symptoms were all misdiagnosed(1 was misdiagnosed as middle ear cholesteatoma and 4 as parotid tumors).Total tumor resection was performed in the 3 patients with preoperative facial paralysis(H-B grade Ⅴ-Ⅵ).Among them,one case of facial paralysis(H-B grade Ⅴ)with a duration of less than one week underwent simultaneous facial-hypoglossal nerve anastomosis,and the facial nerve function achieved postoperative improvement to grade Ⅲ.Tumor dissection was performed in 4 patients with parotid gland tumors resulting in postoperative facial nerve function of grade Ⅰ in one case and grade Ⅴ in 3.One case with the tumor involving the intratemporal segment(tympanic portion)underwent partial tumor resection with postoperative nerve function preserved at grade Ⅰ.Tumors were located in the extratemporal segment(parotid region)in 5 cases,the intratemporal segment in one,and both segments in 2 cases.Postoperative pathology revealed that 6 cases were schwannomas and 2 were neurofibromas.Conclusion The clinical manifestations of facial neuroma are usually subtle,and patients without facial paralysis symptoms are prone to being misdiagnosed.A mass in the deep parotid lobe should raise suspicion of facial neuroma,and preoperative high-resolution imaging examinations are critical for localization and qualitative diagnosis.Preoperative H-B grading is pivotal for surgical planning,a balance must be struck intraoperatively between tumor resection and nerve function preservation.Close postoperative follow-up may reduce the risk of recurrence.关键词
面神经瘤/周围性面瘫/腮腺肿物/影像学检查Key words
Facial neuroma/Peripheral facial paralysis/Tumor of parotid gland/Imaging examination分类
临床医学引用本文复制引用
陈乌娜,林勤,关丽梅,苏文玲..面神经瘤的临床诊治分析[J].中国耳鼻咽喉颅底外科杂志,2025,31(5):81-85,5.
