面神经瘤5例报告并文献复习

Report of Five Cases of Facial Neuromas and Literature Review

目的探讨面神经瘤手术方法、面神经保留及重建方法的选择与面神经功能恢复的关系。方法5例面神经瘤均行肿瘤切除术,2例神经纤维瘤和1例神经鞘瘤术后复发再次手术;1例面神经保留,3例面神经重建,1例面神经成形术。结果5例面神经瘤中神经鞘瘤3例和神经纤维瘤2例,均手术全切除。5例面神经功能按House分级法评估:Ⅰ级1例,Ⅱ-Ⅲ级2例,Ⅲ级1例,V级1例。结论面神经重建应取积极态度,争取一期手术,延期手术应在面肌萎缩前6～8个月内进行。

Objective To explore the operative technique for treatment of facial neuromas, and relationship between reservation or re-establishment of facial nerve and the function of facial nerve. Methods Five patients with facial neuromas undergoing microsurgery for resection of the tumors. The facial nerve was reserved in 1 patient, the facial nerves were reestablished in 3 and the facial neuroplasty was performed in 1. Results The facial neuromas were totally resected in 5 patients. According to House grading, the facial nerve function was grade Ⅰ in 1 patient, grades Ⅱ-Ⅲ in 2, grade Ⅲ in 1, and grade Ⅳ in 1. Conclusions The reestablishment of the facial nerve should be actively performed in one-stage operation in the patients with facial neuromas. If the reestablishment Can not be performed in one- stage operation, the reestablishment should be completed within 6-8 months before the facial muscle atrophy.