腮腺内面神经鞘瘤12例临床病理分析

目的 :分析腮腺内面神经鞘瘤的临床、病理特点 ,以免误诊、误治。方法 :对山东省莱阳中心医院 2 0年间收治的 12例腮腺内面神经鞘瘤的临床、病理特点 ,进行回顾性分析。结果 :6例术前误诊为混合瘤 ,1例误诊为腺样囊性癌 ,1例误诊为淋巴瘤。 2例做了穿刺活检 ,3例做了术中快速病检 ,皆得以确诊。术中保留面神经的 10例 ,虽然术后出现面瘫 ,但于术后 6～ 12月恢复 ,切除面神经颅外段 2例 ,面瘫未见恢复。本组 5例肿瘤来源于面神经总干 ,3例来源于上、下颊支 ,2例来源于颧支 ,2例来源于下颌缘支。肿瘤镜下分型 :囊状型 9例 ,网状型 3例。术后随访 5～ 10年 ,无 1例复发。结论 :此瘤极易误诊 ,确诊有赖于术前 (或术后 )病理检查。术中应尽力保留面神经 ,虽然术中刺激、牵拉面神经等致术后面瘫 ,但大多数患者可自然恢复

Clinical and Pathological Analysis of the 12 Cases of Intraparotid Neurolemmoma of the Facial Nerves

Objective To analyze the clinical and pathological feature of intraparotid neurolemmoma of thefacial nerves. Methods To review the literatures concerned and looking back upon the study of the clinicaland pathological features of the 12 cases of the intraparotid neurolemmoma of the facial nerves that we havetreated in the past 20 years. Results Before operation 6 cases were misdiagnosed for mixed tumors, 1 case foradenoid cystic carcinoma, 1 case for lymphoma. 2 and 3 cases were made definite diagnoses separately by usingneedle biopsy and by histopathology during the operation. The facial nerves in ten of them were reserved in theoperations. Though these patients had palsy after operation, they all recovered after 6 - 10 months. But the othertwo patients did not recover from palsy because their facial nerves had been cut. The tumors of the 12 casesabove come from the trunk and main branches of the facial nerves. Histologically, 9 cases were Antoni A and 3cases Antoni B. 5～10 years after operation, none of the tumors of the 12 cases reoccurred. Conclusions Thiskind of tumor can easily be diagnosed mistakenly. The correct diagnosis is dependent on the clinical and redio-logical examination and histopathological examination before (or during operation). Therefore we should pre-serve as many facial nerves as possible during the operation. Although the stimulation, pull may cause tempo-rary palsy of the facial nerves, most of the patients can recover by themselves.