RESUMO
Unlike the acoustic neuroma, a facial nerve neuroma is an uncommon finding, even in referral clinical centers. Two cases of facial nerve neuromas are presented, with special focus on the importance of adequate radiological imaging techniques and histological characteristics of tumor specimens. Surgical modalities regarding tumor removal as well as facial nerve repair are discussed and the current world literature reviewed.
Assuntos
Neoplasias dos Nervos Cranianos/patologia , Doenças do Nervo Facial/patologia , Neuroma/patologia , Idoso , Audiometria de Tons Puros , Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias dos Nervos Cranianos/cirurgia , Nervo Facial/patologia , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroma/diagnóstico , Neuroma/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Given recent controversy concerning hearing preservation surgery of the acoustic neurinoma, an immunohistochemical study was undertaken to investigate the cochlear nerve-tumor interface. Ten intact medium-sized acoustic neurinomas were studied by means of classic staining procedures and an immunohistochemical technique using monoclonal mouse antibodies to human neurofilaments. Our observations indicate that the cochlear nerve is histologically involved in the tumoral process in those cases in which macroscopically visible adherences between the cochlear nerve and the tumor are present. We were not able to discern a clear cleavage plane. Six of the 10 specimens showed tumoral invasion of the cochlear nerve. Several therapeutic attitudes are discussed in view of these observations and reports from the international literature. In conclusion, the principle of hearing preservation surgery is rejected in favor of total tumor removal in every case in which surgery is indicated.
