Summary:
Swelling in the parotid area belongs to relatively frequent differential diagnostic
problems in otolaryngological area. The swelling is most frequently caused by sialomas of parotid
gland, less frequently by inflammatory pseudotumors. Other more rare disease may be manifested
in the same way. Neurinomas of intraparotid part of facial nerve are rare, but not exceptional
diseases. Every surgeon operation on the parotid region may encounter them. The authors refer to
a rate observation of duplicate neurinoma of facial nerve in a 23-years old woman, manifesting as
a 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, connected
with its minute buccal branch. The smaller tumor in the area of bifurcation was separated from the
nerve with a microscopic control. This procedure was not successful in the larger neurinoma for
virtual disappearance of fascicles due to the pressure. In view of functional functionally less
important branch the tumor was removed and suture of the stumps was not made. The temporary
disorder of facial nerve function of 3rd degree according to House-Brackmann occurring after the
operation completely disappeared until 3 months after the operation.
The preoperation differentiation of neurinoma from sialoma or another neoplasia appears to be
difficult. 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, anastomosis
by interposition or suture of the nerve end to end is recommended. Superficial parotidectomy with
identification and preparation of facial nerve is a precondition of correct peroperation diagnosis
and adequate solution of the condition.
Key words:
facial nerve, parotid gland, neurinoma.
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