累及内耳道的面神经肿瘤的诊断与治疗

张小安; 李煜; 戴春富

doi:10.13201/j.issn.1001-1781.2015.14.001

累及内耳道的面神经肿瘤的诊断与治疗

- 1 赣州市人民医院耳鼻咽喉头颈外科南昌大学附属赣州医院(江西赣州, 341000);
- 2 复旦大学附属眼耳鼻咽喉科医院耳神经颅底外科卫生部听觉医学重点实验室

详细信息

通讯作者: 戴春富,E-mail:cfdai66@163.com

中图分类号: R745.1

收稿日期: 2015-04-13

The management of facial nerve tumors involving the internal auditory canal

- 1 Department of Otorhinolaryngology-Head and Neck Surgery, Ganzhou People's Hospital, Ganzhou, 341000, China;
- 2 Department of Otorhinolaryngology-Skull Base Surgery, Eye Ear Nose Throat Hospital, Fudan University

More Information

Corresponding author: DAI Chunfu, E-mail: cfdai66@163.com

Received Date: 13 April 2015

摘要

摘要: 目的:总结累及内耳道的面神经肿瘤的临床特点,探讨其鉴别诊断方法及治疗措施。方法:回顾总结复旦大学附属眼耳鼻喉科医院2013-01-2015-04期间手术治疗、病理证实的5例累及内耳道的面神经肿瘤患者的临床表现、诊断和治疗经验。结果:累及内耳道面神经肿瘤的主要症状以面瘫伴听力下降最常见。本组5例均为肿瘤全切,其中3例经迷路径路,1例经迷路耳囊径路,1例经颅中窝径路。2例进行了面神经重建,其中1例行面神经舌下神经吻合,1例行耳大神经移植。结论:累及内耳道的面神经肿瘤如出现面瘫H-B 4级以上可考虑手术,应根据患者的听力情况、面神经功能,肿瘤大小及侵犯范围选择相适应的干预策略。
- facial nerve tumors involving the internal auditory canal /
- facial paralysis /
- diagnosis /
- surgery
Abstract: Objective: To summarize the clinical features of the facial nerve tumors involving the internal auditory canal and promote the management of facial nerve tumor.Method: We retrospectively reviewed the clinical manifestations, the experiences of diagnosis and treatment of the facial nerve tumor involving the internal auditory canal. All these 5 cases were enrolled during January 2013 to Apr 2015.Result: Among the 5 cases, 3 cases were facial neurilemmoma and the others were facial neurofibroma. The main symptoms of facial nerve tumors involving the internal auditory canal most commonly were facial paralysis companied with hearing loss. All the patients accepted the surgical treatment with various approaches, 3 cases of translabyrinthine approach, 1 case of middle fossa approach, and 1 case of combination of translabyrinthine and transotic approach. Total tumor resection were achieved in all 5 cases. Facial-hypoglossal nerve anastomosis was performed in one case, another case was undergone great auricular nerve graft.Conclusion: Surgical intervention for patients with facial neuroma involving internal auditory canal should be considered when facial weakness has deteriorated to grade 4. The management should be based on the patient's hearing, facial nerve function, tumor size and invasive extension to select the appropriate surgical procedures.
- facial nerve tumors involving the internal auditory canal /
- facial paralysis /
- diagnosis /
- surgery

HTML全文

参考文献(9)

[1]	张帆, 王宇澄, 戴春富, 等. 面神经瘤27例临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(1):4-4.
[2]	刘良发, 杨仕明, 韩东一, 等. 原发性面神经肿瘤的诊断与治疗[J]. 中华耳鼻咽喉科杂志, 2002, 37(5):352-356.
[3]	迟放鲁, 王正敏, 陈泽宇, 等. 面神经瘤的诊断与处理[J]. 中华耳鼻咽喉头颈外科杂志, 2006, 41(4):262-265.
[4]	ULKU C H, UYAR Y, ACAR O, et al. Facial nerve schwannomas:a report of four cases and a review of the literature[J]. Am J Otolaryngol, 2004, 25:426-431.
[5]	WIGGINS R H, HARNSBERGER H R, SALZMAN K L, et al. The many faces of facial nerve schwannoma[J]. Am J Neuroradiol, 2006, 27:694-699.
[6]	SHIRAZI M A, LEONETTI J P, MARZO S J, et al. Surgical management of facial neuromas:lessons learned[J]. Otol Neurotol, 2007, 28:958-963.
[7]	DOSHI J, HEYES R, FREEMAN S R, et al. Clinical and radiological guidance in managing facial nerve schwannomas[J].Otol Neurotol, 2015,36:892-895.
[8]	KIDA Y, YOSHIMOTO M, HASEGAWA T. Radiosurgery for facial schwannoma[J]. J Nurosurg, 2007,106:24-29.
[9]	HANABUSA K, MORIKAWA A, MURATA T, et al. Acoustic neuroma with malignant transformation:Case report[J]. J Neurosurg, 2001, 95:518-521.