关键词: 腮腺, 面神经, 神经鞘瘤, 囊内摘除术

Abstract: Objective　 To investigate the clinical features, diagnosis, surgical management as well as the prognosis of intraparotid facial nerve schwannoma. Methods 17 cases of intraparotid facial nerve schwannoma from June 1994 to June 2019 were collected from the First People's Hospital of Changzhou (the Third Affiliated Hospital of Soochow University) in oral and maxillofacial surgery department, Information on their age, sex, imaging examination, treatment, relationship between tumor and facial nerve, and impairment of facial nerve function was included. SPASS17.0 software package was used for Fisher's exact test. Results 3 patients (17.6%) had facial paralysis or other neural symptoms and 6 patients (35.29%) were diagnosed by B ultrasound, CT, MRI or FNAC (fine needle aspiration cytology examination) before operation. In one case, nerve grafting was performed after nerve transection because it was impossible to separate the facial nerve from the tumor during the operation. In other 16 cases, stripping surgery and intracapsular enucleation surgery were performed respectively. 10 cases (58.82%) had symptoms of facial nerve impairment postoperatively. Symptoms of nerve injury disappeared in 3 patients, and improved in 7 patients after follow-up for more than one year. The effective rate of preserving facial function was 28.57% (2/7) in stripping surgery group, and the rate was 88.89%（8/9) in Intracapsular enucleation surgery group. All patients were followed up for 12 months to 220 months, and no recurrence and malignant transformation were found. Conclusion Intraparotid facial nerve schwannoma is rare. The diagnosis of schwannoma in parotid region is difficult and needs to be confirmed by pathology. Intracapsular enucleation surgery can protect facial nerve to the greatest extent and is the best surgical scheme for intraparotid facial nerve schwannoma.

Key words: parotid gland, facial nerve, neurilemmoma, Intracapsular enucleation surgery