Duplicate Neurinoma of Facial Nerve in the Area of Parotid Gland

Overview

Swelling in the parotid area belongs to relatively frequent differential diagnosticproblems in otolaryngological area. The swelling is most frequently caused by sialomas of parotidgland, less frequently by inflammatory pseudotumors. Other more rare disease may be manifestedin the same way. Neurinomas of intraparotid part of facial nerve are rare, but not exceptionaldiseases. Every surgeon operation on the parotid region may encounter them. The authors refer toa rate observation of duplicate neurinoma of facial nerve in a 23-years old woman, manifesting asa tumor of parotid gland. In the course of superficial parotidectomy, two tumors were found:a smaller one originating from bifurcation of the stem of facial nerve and a greater one, connectedwith its minute buccal branch. The smaller tumor in the area of bifurcation was separated from thenerve with a microscopic control. This procedure was not successful in the larger neurinoma forvirtual disappearance of fascicles due to the pressure. In view of functional functionally lessimportant branch the tumor was removed and suture of the stumps was not made. The temporarydisorder of facial nerve function of 3rd degree according to House-Brackmann occurring after theoperation completely disappeared until 3 months after the operation.The preoperation differentiation of neurinoma from sialoma or another neoplasia appears to bedifficult. The operation constitutes an attempt to release the rumor from healthy nervous filaments;in the case of disruption of the stem of a functionally important branch of the nerve, anastomosisby interposition or suture of the nerve end to end is recommended. Superficial parotidectomy withidentification and preparation of facial nerve is a precondition of correct peroperation diagnosisand adequate solution of the condition.

Key words:
facial nerve, parotid gland, neurinoma.