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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2008 August;19(2):93-7
Facial nerve paralysis in the early clinical evidence of Warthin’s tumor of the parotid gland
Corbacelli A., Cutilli T.
Institute of Maxillofacial Surgery Department of Surgical Sciences University of L’Aquila, L’Aquila, Italy
The facial nerve paralysis in parotid tumors is usually a sign of malignancy. Only 14 cases of facial neurological damage in histologically benign tumors of the major salivary gland are described in the English-language literature. The authors report an unusual case of facial paralysis present at the first clinical observation of a benign parotid tumor (Warthin’s Tumor). Fine-needle aspiration biopsy (FNAB) suggested an oncocytic process. Intraoperative histological examination of the lesion revealed a Warthin’s tumor. Partial parotidectomy was performed with a microscope-assisted dissection that allowed the preservation of the branches of the facial nerve. A complete functional recovery of the left facial nerve was observed in the following 30 postoperative days. No recurrence of neurologic deficit and tumor relapse have been observed at three years follow-up. The authors believe that in parotid benign tumors the neurological damage may be caused by compression and stretching of the nerve due to the rapid enlargement of the tumor or its trappement in the surrounding areas undergoing inflammatory and fibrous reactions.