Kinouchi H, Mikawa S, Suzuki A, Sasajima T, Tomura N, Mizoi K
Department of Neurosurgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
Neurosurgery. 2001 Oct;49(4):999-1003; discussion 1003-4. doi: 10.1097/00006123-200110000-00041.
Two rare cases of middle cranial fossa neuroma located in the epidural space at the petrous apex are reported.
Two women, aged 58 and 49 years, were admitted to our hospital with diagnoses of cavernous sinus tumor. Analysis of preoperative computed tomography scans showed bone erosion of the petrous apex, and magnetic resonance imaging demonstrated the presence of an extradural mass located along the course of the petrous internal carotid artery in both patients.
The tumor was completely removed in one patient and partially removed in the other by use of the epidural middle cranial fossa transpetrosal approach. In both patients, histological examination of tumor specimens revealed neuroma.
Because surgical exploration revealed that these epidural tumors adhered tightly to the internal carotid artery, and because they had no relationship to the trigeminal nerve, facial nerve, or proximal greater superficial petrosal nerve, in our opinion, these tumors originated from the distal portion of the greater superficial petrosal nerve or the deep petrosal nerve. These neuromas were mainly found in a site under the cavernous sinus at the petrous apex, a location not previously reported.
报告两例位于岩尖硬膜外间隙的中颅窝神经瘤罕见病例。
两名女性患者，年龄分别为58岁和49岁，因海绵窦肿瘤诊断入院。术前计算机断层扫描分析显示岩尖骨质侵蚀，磁共振成像显示两名患者均存在沿岩部颈内动脉走行的硬膜外肿块。
一名患者肿瘤完全切除，另一名患者采用硬膜外中颅窝经岩骨入路部分切除。两名患者肿瘤标本的组织学检查均显示为神经瘤。
由于手术探查发现这些硬膜外肿瘤与颈内动脉紧密粘连，且与三叉神经、面神经或岩浅大神经近端无关，我们认为这些肿瘤起源于岩浅大神经远端或岩深神经。这些神经瘤主要见于岩尖海绵窦下方的部位，此部位此前未见报道。
