Intraparotid neurofibroma of the facial nerve.

Background: Solitary intraparotid facial neurofibromas are extremely rare. These tumours arise from Schwann cells, in most cases as a manifestation of neurofibromatosis. In an intraparotid localisation, they can mimic other p arotideal tumours. Due to their slow growth, they may be clinically inappar ent for a long time. Case report: We present the case of a patient with a r ight intraparotid neurofibroma originating from the facial nerve. He noted a slight facial weakness for the last three years and dullness over the pre auricular area. On operation, all facial nerve branches were incorporated i n the tumour mass. A total resection via monitoring technique of facial ner ve function was performed. Postoperatively, the patient suffered from an in complete facial palsy. Conclusion: This case highlights particularly the im portantce of a concise diagnostic work-up of every facial palsy. Precise hi stological diagnosis is particularly essential because of the different bio logical behaviour of neurofibromas in contrast to neurinomas. With preopera tive facial palsy the chance of facial nerve preservation decreases. Clinic al and operative experience with parotid gland neurofibromas shows that rec overy of facial nerve defects is mostly incomplete.