Misdiagnosis of facial nerve schwannoma:a retrospective analysis and literature reviews
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摘要: 目的:总结分析面神经鞘膜瘤误诊的原因,以期提高临床医生对面神经鞘膜瘤的认识。方法:回顾性分析16例面神经鞘膜瘤患者,收集这些患者的初发症状、诊疗经过、影像学结果、手术情况、预后等资料。结果:16例患者中10例曾被误诊,6例在外院误诊为突发性面瘫,2例在外院误诊为中耳胆脂瘤,2例在术前诊断为听神经瘤。前8例在完善MRI检查后得以确诊,后2例仅依靠术中所见而确诊。结论:对于面瘫患者建议及时完善MRI检查排除面神经瘤的可能,尤其是复发性或进行性面瘫、长期耳漏及面瘫患者。对于孤立的内听道、桥小脑角占位,即使患者仅存在听觉症状而无面神经症状,仍需考虑非典型面神经瘤的可能并了解患者对治疗方案的选择情况。Abstract: Objective:To analyze the clinical features of patients with facial nerve schwannoma to raise awareness of the disease and potential future treatments.Method:A series of 16 cases with facial nerve schwannoma wereretrospective analyzed, including initial symptoms, medical and treatment history, imaging findings, surgical technique and outcome.Result:Ten cases of them were initially misdiagnosed:six cases as sudden facial paralysis, two as cholesteatoma and two as vestibular schwannomas. The diagnosis were revised after MRI examination for first eight cases, and other two patients were identified as the FNS after the surgery.Conclusion:MRI is a very valuable examination for the diagnosis of facial schwannoma, especially for patients with recurrent or progressive facial paresis, long-term otorrhea with facial paresis. The possibility of atypical facial schwannoma should be considered for the patients with isolated internal auditory canal and cerebellopontine angle tumor presenting only auditory symptoms without facial nerve symptoms.
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Key words:
- facial nerve /
- schwannoma /
- diagnostic errors
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