Netting Operation to Control the Neurofibroma on Face

ABSTRACT

When the facial neurofibroma is involved with craniofacial skeleton and causes dysplastic bony anomaly, the deformity or the defect can be corrected by craniofacial surgery. However, it is impossible to radically remove all the involved facial soft tissues and facial nerve. Therefore, the partial excision may cause recurrence of the disease and thus result in the deformity of facial soft tissue because of the persisting force of gravity. We used Teflon mesh as replacement material for destroyed subcutaneous tissue or substitute for superficial fascia damaged by tumor infiltration. This method enables to prevent the deformity of facial soft tissue caused by recurrence and gravity effect after partial excision and to control the tumor growth. We performed suspension into the superio-posterior direction of Teflon mesh like the fish netting procedure after partial excision in attempt to prevent further progress of remnant tumor, thus compressing or capturing remnant neurofibroma. Surgical correction was performed for 8 patients of neurofibroma and all the patients were followed up for 5 or 6 years. According to the results, the Teflon mesh, which is inserted for replacement for subcutaneous tissue or superficial fascia after partial excision of the tumor mass, is well maintained as part of layers of facial structure along with collagen. No tumor proliferation under mesh was observed. Deformity of facial contour caused by recurrence of tumor or gravity effect was not observed. Our method using Teflon mesh for replacement of destroyed subcutaneous tissue and compression on the remnant tumor is considered a proper treatment modality for facial neurofibroma, thus hereby we report our studies with the review of the literature.