CAJ | 학술논문

目的：分析腮腺内面神经鞘瘤的临床、病理特点，以免误诊、误治。方法：对山东省莱阳中心医院20年间收治的12例腮腺内面神经鞘瘤的临床、病理特点，进行回顾性分析。结果：6例术前误诊为混合瘤，1例误诊为腺样囊性癌，1例误诊为淋巴瘤。2例做了穿刺活检，3例做了术中快速病检，皆得以确诊。术中保留面神经的10例，虽然术后出现面瘫，但于术后6～12月恢复，切除面神经颅外段2例，面瘫未见恢复。本组5例肿瘤来源于面神经总干，3例来源于上、下颊支，2例来源于颧支，2例来源于下颌缘支。肿瘤镜下分型：囊状型9例，网状型3例。术后随访5～10年，无1例复发。结论：此瘤极易误诊，确诊有赖于术前(或术后)病理检查。术中应尽力保留面神经，虽然术中刺激、牵拉面神经等致术后面瘫，但大多数患者可自然恢复。
목적：분석시선내면신경초류적림상、병리특점，이면오진、오치。방법：대산동성래양중심의원20년간수치적12례시선내면신경초류적림상、병리특점，진행회고성분석。결과：6례술전오진위혼합류，1례오진위선양낭성암，1례오진위림파류。2례주료천자활검，3례주료술중쾌속병검，개득이학진。술중보류면신경적10례，수연술후출현면탄，단우술후6～12월회복，절제면신경로외단2례，면탄미견회복。본조5례종류래원우면신경총간，3례래원우상、하협지，2례래원우권지，2례래원우하합연지。종류경하분형：낭상형9례，망상형3례。술후수방5～10년，무1례복발。결론：차류겁역오진，학진유뢰우술전(혹술후)병리검사。술중응진력보류면신경，수연술중자격、견랍면신경등치술후면탄，단대다수환자가자연회복。
Objective To analyze the clinical and pathological feature of intraparotid neurolemmoma of thefacial nerves. Methods To review the literatures concerned and looking back upon the study of the clinicaland pathological features of the 12 cases of the intraparotid neurolemmoma of the facial nerves that we havetreated in the past 20 years. Results Before operation 6 cases were misdiagnosed for mixed tumors, 1 case foradenoid cystic carcinoma, 1 case for lymphoma. 2 and 3 cases were made definite diagnoses separately by usingneedle biopsy and by histopathology during the operation. The facial nerves in ten of them were reserved in theoperations. Though these patients had palsy after operation, they all recovered after 6 - 10 months. But the othertwo patients did not recover from palsy because their facial nerves had been cut. The tumors of the 12 casesabove come from the trunk and main branches of the facial nerves. Histologically, 9 cases were Antoni A and 3cases Antoni B. 5～10 years after operation, none of the tumors of the 12 cases reoccurred. Conclusions Thiskind of tumor can easily be diagnosed mistakenly. The correct diagnosis is dependent on the clinical and redio-logical examination and histopathological examination before (or during operation). Therefore we should pre-serve as many facial nerves as possible during the operation. Although the stimulation, pull may cause tempo-rary palsy of the facial nerves, most of the patients can recover by themselves.