Intraparotid Facial Nerve Schwannoma: A Comprehensive Review of 70 Cases at One Single Institution.

in Oral diseases by Lingli Huang, Wei Xu, Wenya Zhu, Hao Lu, Shengwen Liu, Wenjun Yang, Wanlin Xu

TLDR

  • The study analyzed 70 IPFNS patients and proposed a therapeutic algorithm based on tumor location, facial nerve function, and patients' preferences.
  • MRI is the preferred diagnostic method, and surgical intervention is recommended based on tumor type and location.
  • Preoperative consideration of facial nerve function, tumor location, and patients' preferences is crucial for decision-making in IPFNS treatment.

Abstract

The current study aimed to analyze the clinical characteristics, diagnosis, and surgical outcomes of intraparotid facial nerve schwannoma (IPFNS) and propose a more definitive therapeutic algorithm for IPFNS. Between January 2018 and December 2023, all the cases of IPFNS at our single institution were retrospectively reviewed. In total, 70 patients were included in this study. Among them, 23 (32.3%) were men and 47 (67.7%) were women. The patients commonly presented with a painless parotid mass, and three patients complained of facial paralysis. Magnetic resonance imaging (MRI) had the highest diagnostic efficacy (37.1%) among all the evaluation techniques used. Marchioni's classification and surgical method were significantly associated with postoperative facial function. In terms of surgical interventions, stripping surgery was suitable for type A tumors, while for types B, C, and D tumors, intracapsular enucleation with a microscope was recommended to decrease the influence of the procedure on facial nerve function. IPFNS is a rare disease, whose diagnosis and management remain challenging. MRI is the preferred preoperative diagnostic method. Preoperative facial nerve function, tumor location, and patients' preferences are key factors in the decision-making process of IPFNS treatment.

Overview

  • The study aimed to analyze the clinical characteristics, diagnosis, and surgical outcomes of intraparotid facial nerve schwannoma (IPFNS) and propose a therapeutic algorithm.
  • A total of 70 patients with IPFNS were retrospectively reviewed between 2018 and 2023.
  • The study aimed to identify the key factors in the diagnosis and treatment of IPFNS to develop a definitive therapeutic algorithm.

Comparative Analysis & Findings

  • Magnetic resonance imaging (MRI) had the highest diagnostic efficacy (37.1%) among all the evaluation techniques used.
  • Marchioni's classification and surgical method were significantly associated with postoperative facial function.
  • Stripping surgery was suitable for type A tumors, while intracapsular enucleation with a microscope was recommended for types B, C, and D tumors to minimize the influence on facial nerve function.

Implications and Future Directions

  • IPFNS is a rare disease with a challenging diagnosis and management, and MRI is the preferred preoperative diagnostic method.
  • Preoperative facial nerve function, tumor location, and patients' preferences are key factors in the decision-making process of IPFNS treatment.
  • Future studies may focus on exploring novel diagnostic and treatment methods to improve the management of IPFNS.
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