title: Intracapsular microenucleation technique in a case of intraparotid facial nerve schwannoma. Technical notes for a conservative approach.
abstract: We report a rare case of a large intraparotid facial nerve schwannoma (IFNS) in a 51-year-old female who presented with a painless, slow growing left parotid mass without peripheral facial nerve palsy, with non-specific findings at preoperative diagnostic work-up, that was treated with conservative surgery. Management of IFNS is very challenging because the diagnosis is often made intra-operatively, and in most cases resection may lead to severe facial nerve paralysis, with important aesthetic sequelae. Our experience suggests a new surgical option, namely intra-capsular enucleation using a microscope, currently used for schwannomas arising from a major peripheral nerve, which should be a safe and reliable treatment for IFNS. This surgical technique is the first experience of intracapsular microenucleation of facial nerve schwannoma described in the literature and allows preservation of the nerve without resection and reconstruction.
authors.affiliation: Department of Head and Neck Surgery, Institute of Otorhinolaryngology; Catholic University of Medicine and Surgery, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rigante
authors.affiliation: Department of Head and Neck Surgery, Institute of Otorhinolaryngology; Catholic University of Medicine and Surgery, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Petrelli
authors.affiliation: Department of Head and Neck Surgery, Institute of Otorhinolaryngology; Catholic University of Medicine and Surgery, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: DE Corso
authors.affiliation: Department of Head and Neck Surgery, Institute of Otorhinolaryngology; Catholic University of Medicine and Surgery, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Paludetti
mesh_terms: D000072700:Conservative Treatment; D003390:Cranial Nerve Neoplasms / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010306:Parotid Gland
keywords: Facial nerve palsy; Intraparotid facial nerve schwannoma; Microenucleation in peripheral nerve; Parotid tumour surgery