Schwannoma del nervio facial intraparotídeo: un dilema terapéutico

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Abstract

Los schwannomas del nervio facial intraparotídeos son tumores benignos poco frecuentes, suponiendo frecuentemente un reto diagnóstico y terapéutico. La mayoría de los pacientes presentan una masa parotídea asintomática y las pruebas de imagen y la punción con aguja fina no suelen ser concluyentes en el diagnóstico. Tras la revisión de la literatura a propósito de un caso, pretendemos proporcionar cierta guía para el tratamiento de esta rara patología.

Translated abstract

Intraparotid schwannomas of the facial nerve are uncommon benign tumors that present a challenge in diagnosis and management. An asymptomatic parotid mass is the main clinical presentation, and image studies and fine-needle aspiration biopsy do not usually give a conclusive diagnosis. The main purpose of this study of a case report and a literature review is to provide some surgical guidance for the treatment of this rare pathology.

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Most cited references 27

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Critical literature review on the management of intraparotid facial nerve schwannoma and proposed decision-making algorithm.

Matteo Alicandri-Ciufelli, Daniele Marchioni, Francesco Mattioli … (2009)

Management of intraparotid facial nerve schwannomas (IFNS) is very challenging because the diagnosis is often made intra-operatively and in most cases, resection could lead to severe facial nerve (FN) paralysis, with important aesthetic consequences. Articles in the English language focused on the management of FN schwannoma have been selected and critically reviewed. A decision-making algorithm is proposed. In the case of type A or B neoplasms, or in case of a pre-operative FN House-Brackmann (HB) grade IV or worse, the authors would favor a resection of the IFNS and (where necessary) a reconstruction of the nerve. In the case of pre-operative HB grade III or better and type C or D neoplasms, patients would undergo an intra-operative biopsy to rule out malignancy, and a possible conservative management could be adopted. Localization and adherences of IFNS, as well as pre-operative FN function are important factors that must be considered in the decision-making process for IFNS to optimize the functional outcomes.

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Diagnosis and management of intraparotid facial nerve schwannoma.

Qin MA, Hong Suk Song, Pu Zhang … (2010)

Our objective was to provide the management guidelines for facial nerve schwannomas (FNSs) presenting as a parotid mass. The study is a case report and literature review. Four clinical cases of patients with an asymptomatic parotid mass diagnosed as FNS are presented. The patient's presentation, the diagnostic algorithm and surgical rationale are discussed. A review of the literature on FNSs is presented. Intraparotid FNSs are an extremely rare entity and are rarely diagnosed preoperatively. Intraoperatively, conservative biopsy in a non-functional part of the lesion can be used to make the diagnosis. Most of the FNSs of patients with normal facial nerve function could be dissected off the nerve trunk without losing FN function. FNS patients with preoperatively abnormal FN function should be managed conservatively or undergo reconstruction with nerve graft after tumour resection. Copyright (c) 2009 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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Intraoperative diagnosis of facial nerve schwannoma at parotidectomy.

Ritvik Mehta, Daniel G. Deschler (2016)

Our objective was to provide a diagnostic algorithm for facial nerve schwannomas presenting as a parotid mass. The study is a case report and literature review. A clinical case of a patient with an asymptomatic parotid mass diagnosed as a facial nerve schwannoma intraoperatively is presented. The patient's presentation and the diagnostic algorithm and surgical rationale are discussed. A review of the literature on facial nerve schwannomas is presented. Intraparotid facial nerve schwannomas are an extremely rare entity and are rarely diagnosed preoperatively. Most of these benign lesions can be managed conservatively with the goal of preserving facial nerve function. Intraoperatively, fine-needle aspiration and/or conservative biopsy in a nonstimulating portion of the lesion can be used to make the diagnosis.

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Author and article information

Contributors

Paula Barba-Recreo: Role: ND

Javier Arias Gallo: Role: ND

María José Morán Soto: Role: ND

Edurne Palacios Weiss: Role: ND

Miguel Burgueño García: Role: ND

Journal

Journal ID (publisher-id): maxi

Title: Revista Española de Cirugía Oral y Maxilofacial

Abbreviated Title: Rev Esp Cirug Oral y Maxilofac

Publisher: Sociedad Española de Cirugía Oral y Maxilofacial (Barcelona, Barcelona, Spain )

ISSN (Print): 1130-0558

ISSN (Electronic): 2173-9161

Publication date (Print and electronic): September 2015

Volume: 37

Issue: 3

Pages: 153-157

Affiliations

[02] Madrid orgnameHospital Sanitas La Moraleja orgdiv1Servicio de Cirugía Oral y Maxilofacial España

[01] Madrid orgnameHospital La Paz orgdiv1Servicio de Cirugía Oral y Maxilofacial España

Article

Publisher ID: S1130-05582015000300006

DOI: 10.1016/j.maxilo.2014.01.004

SO-VID: 63282ea3-d40b-4d9a-9a11-ce2fd113bfe2

License:

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

History

Date accepted : 09 January 2014

Date received : 29 August 2013

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Figures: 0, Tables: 0, Equations: 0, References: 11, Pages: 5

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SciELO Spain

Keywords: Schwannoma del nervio facial,Tumor parotídeo,Parotidectomía,Parálisis facial,Facial nerve schwannoma,Parotid tumor,Parotidectomy,Facial paralysis

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Keywords: Schwannoma del nervio facial, Tumor parotídeo, Parotidectomía, Parálisis facial, Facial nerve schwannoma, Parotid tumor, Parotidectomy, Facial paralysis

Schwannoma del nervio facial intraparotídeo: un dilema terapéutico Translated title: Intraparotid facial nerve schwannoma: a therapeutic dilemma

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Abstract

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Most cited references 27

Critical literature review on the management of intraparotid facial nerve schwannoma and proposed decision-making algorithm.

Diagnosis and management of intraparotid facial nerve schwannoma.

Intraoperative diagnosis of facial nerve schwannoma at parotidectomy.

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