Facial Nerve Paralysis associated with benign humour of the parotid (Warthin’s humour)

Background. Ward and Hendrik (1950) described the first case of partial paresis of the facial nerve associated with mixed tumor. Wilkie and White described 1 case (1964), La Ventura and Moore 1 case (1969), Cimorra et al. 1 case (1972), Mamakos et al. 1 case (1977), and Blevins et al. 2 cases (1992). Papangelou and Alkalai (1982) described 1 case of complete paralysis of the facial nerve associated with oncocytoma. The first case of the facial paralysis associate with Warthin’s tumour has been describedin 1985 by Lesser and Spector. Other cases were described by Whillis et al. and De Lozier et al. in 1989, O’Dwyer et al. in 1990, Newman et al. in 1993, and Koide et al. in 1994. The AA report a case of paresis of the facial nerve in Warthin’s tumour of the parotid. Study design. A man 56 years old showed swelling of the left parotid and peripheral deficit of the left facial nerve (“marginalis mandibulae”). Ecography and MR were performed. FNAB suggested an oncocytic process with inflammatory alterations. Partial parotidectomy was executed after intraoperative histological diagnosis (Warthin’s tumour). Microscope-assisted dissection allowed the preservation of the smaller branches of the facial nerve. Results. In the post-operative period the AA observed complete recovery of the functionality of left facial nerve ( two years follow-up). Conclusions. Parotid swelling associated with facial paresis is usually considered an unfavourable clinical symptom. This clinical observation shows that also in benign tumours of the parotid the paralysis of the facial nerve may occurs. The literature relates only 14 cases, 6 of which are Warthin’s tumors. The AA pointed out that the lesion should be studied and affrontata by careful protocol (MR, FNAB, intraoperatory histological examination). This diagnostic and surgical management can allows a conservative treatment and the complete neurological recovery.