Neoplasms of the facial nerve presenting as a parotid mass are uncommon. In the absence of a facial palsy their origin from the nerve is usually diagnosed intraoperatively. The majority of these neurogenic neoplasms are schwannomas, with neurofibromas occurring rarely. Although the Schwann cell is the key element in both, they have distinct histopathological characteristics, and their clinical course and management often differs. The first reported case of an intraparotid facial nerve schwannoma in a child in the English literature is presented.
The traditional meatoplasty operations performed for chronic otitis externa, which has entered the ‘fibrotic’ phase, are often unsatisfactory because the results in terms of canal patency, hearing gain and patient satisfaction are variable. Although the use of laser in chronic ear surgery is well recognized, it has not been previously reported as a meatoplasty technique. Ten KTP laser meatoplasty operations were performed on eight patients with chronic otitis externa. This pilot study shows the technique to be effective, fast and with a high patient satisfaction rate in the short-term (mean follow-up period 9.3 months). The average increase in hearing thresholds was 24 dB HL. Significant patient benefit was obtained in at least six out of eight patients using the Belfast rule of thumb. The technique has many advantages over the traditional meatoplasty operations but the long-term results require evaluation.
Schwannomas are the most common benign tumors of peripheral nerves but are rare in adults. They have an extremely slow rate of growth before the onset of symptoms such as pain, paresthesia, and tingling. Giant schwannomas of the extremities can significantly affect the quality of life. With a correct diagnosis, the tumor can be extirpated with preservation of nerve function and a very low risk of recurrence. A case of a symptomatic giant schwannoma on thenar eminence of the right hand in an adult male is discussed in this report.
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