Park Hun Yi, Kim Sung Huhn, Son Eun Jin, Lee Ho-Ki, Lee Won-Sang
Department of Otorhinolaryngology, Yonsei University, College of Medicine, Seoul, South Korea.
Otol Neurotol. 2007 Apr;28(3):376-80. doi: 10.1097/01.mao.0000265191.24131.ed.
To investigate the capability of preoperative evaluations in predicting the precise anatomic origin of intracanalicular tumors.
We conducted a retrospective case review.
Tertiary referral center.
A total of 11 patients (8 men and 3 women, 26-70 years old) with intracanalicular tumors who were treated surgically were included.
Pure-tone average, auditory brainstem response, caloric test, and temporal magnetic resonance imaging were done in all 11 patients. Electroneuronography has only been performed since 2003, and only 3 patients were evaluated.
Preoperative symptoms, pure-tone average, auditory brainstem response, caloric test, electroneuronography, and magnetic resonance imaging were compared between patients with facial nerve schwannomas and patients with vestibular schwannomas.
Postoperatively, facial nerve schwannomas were diagnosed pathologically in 2 (18%) of 11 patients. There were not any clues suggesting facial nerve schwannoma in preoperative evaluations.
A facial nerve schwannoma may be misdiagnosed as a vestibular schwannoma, especially when the tumor is confined to the internal auditory canal. There are no useful preoperative evaluation tools in predicting the precise nerve origin of intracanalicular tumors. These emphasize the need to fully inform the patient preoperatively.
探讨术前评估预测管内肿瘤确切解剖起源的能力。
我们进行了一项回顾性病例分析。
三级转诊中心。
共纳入11例接受手术治疗的管内肿瘤患者（8例男性，3例女性，年龄26 - 70岁）。
对所有11例患者进行了纯音平均听阈、听性脑干反应、冷热试验及颞部磁共振成像检查。自2003年起仅对3例患者进行了神经电图检查。
比较面神经鞘瘤患者和前庭神经鞘瘤患者的术前症状、纯音平均听阈、听性脑干反应、冷热试验、神经电图及磁共振成像检查结果。
术后，11例患者中有2例（18%）经病理诊断为面神经鞘瘤。术前评估中未发现任何提示面神经鞘瘤的线索。
面神经鞘瘤可能被误诊为前庭神经鞘瘤，尤其是当肿瘤局限于内听道时。目前尚无有效的术前评估工具来预测管内肿瘤的确切神经起源。这些情况强调了术前充分告知患者的必要性。
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