腮腺内面神经鞘瘤的诊断与治疗

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。

Diagnosis and management of intraparotid facial nerve schwannoma

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.