耳下腺内顔面神経鞘腫の2症例

Two Cases of Intraparotid Facial Neurinoma

　はじめに

　顔面神経鞘腫が耳下腺腫瘍全体に占める割合は，0.4〜3.4％^1〜4）といわれており比較的少ない疾患である。術前に診断が確定する症例は少なく，治療方針に統一した見解がなつのが現状である。

　今回われわれは，耳下腺内顔面神経鞘腫で術中の肉眼所見や迅速診断で診断が確定し，被膜外摘出術によって顔面神経を保存し得た2例を経験した。今回，顔面神経鞘腫に対する診断確定の時期と治療方針に関して，文献的考察を加えて検討したので報告する。

Case 1 was a 45-year-old male, who was acciden-tally found a left intraparotid facial nerve schwan-noma, during post-operative following-up period of acoustic tumor in the same side.

Case 2 was a 26-year-old female who noticed a mass lesion in her left parotid gland.

Both cases had no remarkable symptoms. Thesetumors were growing slowly. Fine needle aspiration biopsy showed class I~II.

During operation, a yellow encapsulated tumor arising from the facial nerve was observed, and we removed the tumor totally in each case. After opera-tion, facial palsy was occurred temporally, however, recovering within several months. We found no recurrence in both cases.

We consider that the best treatment for intrapa-rotid facial nerve schwannoma is total removal of the tumor without injuring the facial nerve, and recommend intraoperative pathological examina-tion to diagnose this tumor.