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目的探讨面神经鞘膜瘤的诊断和治疗。方法分析我科2002～2004年收治并于术中诊断为面神经鞘膜瘤患者的临床资料,复习面神经鞘膜瘤诊断和治疗的有关文献。结果2例患者于术中诊断为面神经鞘膜瘤,其中1例行肿瘤切除,并取耳大神经行面神经移植吻合;另1例行腮腺深叶肿瘤切除。结论原发于面神经的良性肿瘤,由于病变部位的不同所引起的临床表现不同为诊断带来了困难。在临床症状和全面体检的基础上,影像学检查可确定病变范围及其与周围组织的关系,并为手术进路的选择提供必要的信息。治疗原则是全部切除肿瘤组织,保留或恢复面神经功能,保存听力。影响术后面神经功能恢复的主要因素是术前面神经损伤时间的长短,损伤时间达1年以上,术后面神经功能恢复较差,而病变部位和术前面神经功能的分级并不影响面神经功能的恢复。
Objective To investigate the diagnosis and treatment of facial nerve sheath tumor. Methods The clinical data of patients with facial nerve sheath tumor diagnosed and treated intraoperatively from 2002 to 2004 in our department were reviewed. The related literature on diagnosis and treatment of facial nerve sheath tumor was reviewed. Results Two patients were diagnosed as facial nerve sheath tumor during operation, one of them underwent resection of the tumor and facial nerve transplantation. The other one underwent excision of the parotid deep-leaf tumor. Conclusion Primary benign tumors of the facial nerve, due to the different parts of the lesions caused by different clinical manifestations for the diagnosis of difficulties. On the basis of clinical symptoms and comprehensive physical examination, imaging examination can determine the extent of the lesion and its relationship with the surrounding tissue, and provide the necessary information for the choice of surgical approach. The principle of treatment is the total removal of tumor tissue, retain or restore facial nerve function, save hearing. The main factors affecting the functional recovery of the facial nerve are the length of time before the injury of the facial nerve, the injury time is over one year, and the functional recovery of the facial nerve is poor. The classification of the lesion and the function of the facial nerve does not affect the recovery of the facial nerve .