面神经鞘膜瘤误诊现状分析并文献回顾

韩奎广; 蔡林彬; 贾欢; 汪照炎; 吴皓; 杨军

doi:10.13201/j.issn.1001-1781.2016.20.006

面神经鞘膜瘤误诊现状分析并文献回顾

- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科上海交通大学医学院耳科学研究所上海耳鼻疾病转化医学重点实验室(上海, 200092)

详细信息

通讯作者: 贾欢,E-mail:huan_jia_orl@163.com; 杨军,E-mail:otology-xinhua@hotmail.com

中图分类号: R745.12

收稿日期: 2016-04-26

Misdiagnosis of facial nerve schwannoma:a retrospective analysis and literature reviews

- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Shanghai Jiaotong University School of Medicine Ear Institute; Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, 200092, China

More Information

Corresponding authors: JIA Huan ; YANG Jun

Received Date: 26 April 2016

摘要

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。
- 面神经 /
- 神经鞘膜瘤 /
- 误诊
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.
- facial nerve /
- schwannoma /
- diagnostic errors

HTML全文

参考文献(11)

[1]	MCMONAGLE B,AL-SANOSI A,CROXSON G,et al.Facial schwannoma:results of a large case series and review[J].J Laryngol Otol,2008,122:1139-1150.
[2]	GNTHER M,DANCKWARDT-LILLIESTRÖM N,GUDJONSSON O,et al.Surgical treatment of patients with facial neuromas--a report of 26consecutive operations[J].Otol Neurotol,2010,31:1493-1497.
[3]	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):4-7.
[4]	SELLARI-FRANCESCHINI S,BERRETTINI S,BRUSCHINI P,et al.Neuroma of the facial nerve masked by chronic otitis media[J].Am J Otol,1994,15:441-444.
[5]	李阳,高志强,姜鸿,等.伴或不伴轻微面神经麻痹的面神经鞘瘤的诊治分析[J].中华耳鼻咽喉头颈外科杂志,2012,47(7):549-553.
[6]	叶星,阎志毓,梁晓杰,等.面神经鞘瘤误诊原因分析[J].耳鼻咽喉-头颈外科,2003,10(1):9-10.
[7]	MINOVI A,VOSSCHULTE R,HOFMANN E,et al.Facial nerve neuroma:surgical concept and functional results[J].Skull Base,2004,14:195-200.
[8]	ROOS D E,PATEL S G,POTTER A E,et al.When is an acoustic neuroma not an acoustic neuroma?Pitfalls for radiosurgeons[J].J Med Imaging Radiat Oncol,2015,59:474-479.
[9]	MOWRY S,HANSEN M,GANTZ B.Surgical management of internal auditory canal and cerebellopontine angle facial nerve schwannoma[J].Otol Neurotol,2012,33:1071-1076.
[10]	KANIA R E,HERMAN P,TRAN BA HUY P.Vestibular-like facial nerve schwannoma[J].Auris Nasus Larynx,2004,31:212-219.
[11]	BACCIU A,MEDINA M,BEN AMMAR M,et al.Intraoperatively diagnosed cerebellopontine angle facial nerve schwannoma:how to deal with it[J].Ann Otol Rhinol Laryngol,2014,123:647-653.