Furuta S, Hatakeyama T, Zenke K, Nagato S
Department of Neurosurgery, Uwajima City Hospital, Ehime.
Neurol Med Chir (Tokyo). 2000 Oct;40(10):528-31. doi: 10.2176/nmc.40.528.
A 46-year-old male presented with a huge facial schwannoma extending into both the middle cranial fossa and the cerebellopontine angle but without manifesting facial nerve palsy. Neurological examination on admission revealed no deficits except for speech disturbance. Computed tomography showed a multicystic tumor extending into the middle cranial fossa and the cerebellopontine angle, with destruction of the petrous bone. The tumor was totally grossly removed. Histological examination identified schwannoma. Total facial nerve palsy appeared postoperatively, but hearing acuity was preserved at a useful level. Facial nerve palsy is one of the most typical symptoms in patients with facial schwannoma, but is not always manifested even if the tumor extends into both the middle cranial fossa and the cerebellopontine angle.
一名46岁男性患者,患有巨大的面部神经鞘瘤,肿瘤延伸至中颅窝和桥小脑角,但未出现面神经麻痹。入院时神经系统检查除言语障碍外无其他缺损。计算机断层扫描显示一个多囊性肿瘤延伸至中颅窝和桥小脑角,伴有岩骨破坏。肿瘤被完全肉眼切除。组织学检查确诊为神经鞘瘤。术后出现了完全性面神经麻痹,但听力保留在有用水平。面神经麻痹是面部神经鞘瘤患者最典型的症状之一,但即使肿瘤延伸至中颅窝和桥小脑角,也并非总是出现。