Radical intracapsular microenucleation technique for exclusively intraparotid facial nerve schwannoma: Long-term follow-up review

• Published in: Journal of cranio-maxillo-facial surgery 2016-12, Vol.44 (12), p.1963-1969
• Main Authors: Zheng, Zhiwei, D.D.S, Li, Jun, D.D.S, Shen, Yi, M.D., D.D.S, Xu, Liqun, D.D.S, Sun, Jian, M.D., D.D.S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Cranial Nerve Neoplasms - diagnosis; Cranial Nerve Neoplasms - pathology; Cranial Nerve Neoplasms - surgery; Dentistry; Diagnostic Errors; Facial Nerve - physiopathology; Facial Nerve - surgery; Facial Nerve Diseases - diagnosis; Facial Nerve Diseases - pathology; Facial Nerve Diseases - surgery; Female; Follow-Up Studies; House-Brackmann Grade; Humans; Intracapsular microenucleation; Intraparotid facial nerve schwannoma; Male; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neurilemmoma - diagnosis; Neurilemmoma - pathology; Neurilemmoma - surgery; Parotid Gland - pathology; Parotid Gland - surgery; Parotid Neoplasms - diagnosis; Surgery; Young Adult
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.09.012

Summary Purpose To evaluate the efficacy and long-term outcome of radical intracapsular microenucleation technique for the treatment of exclusively intraparotid facial nerve schwannoma (IFNS). Materials and Methods From 1996 to 2015, IFNSs closely adherent to the facial nerve without intratemporal involvement were selected for this study. IFNSs were subdivided into an intracapsular microenucleation group and a resection with reconstruction group. Facial nerve function was assessed using the House-Brackmann Grading system. The study sample consisted of 28 patients who were followed up for 5.75 years (range, 1-15 years). Results Of the 28 patients, 18 IFNSs were from the main trunk. Radical intracapsular microenucleation was performed in 9 patients, resection with reconstruction in 7 patients, and only biopsy in 2 patients. Nine patients who received intracapsular microenucleation recovered to House-Brackmann Grade I (55.6%) or Grade II (44.4%), in comparison to the 7 patients from resection group (Grade III, 28.6%; Grade IV, 42.9%; Grade V, 28.6%). The other 10 IFNSs from the distal branches maintained favorable nerve function with either of the treatments. Tumor recurrence was not observed except for the two patients with only biopsy. Conclusion Radical intracapsular microenucleation with nerve preservation was a safe and reliable treatment for IFNS, especially for the IFNS from the main trunk.