Yanagihara N, Segoe M, Gyo K, Ueda N
Department of Otolaryngology, Ehime University School of Medicine, Shigenobu-cho, Japan.
Am J Otol. 1991 May;12(3):199-202.
This is a report of a case presenting recurrent facial palsy due to inflammatory pseudotumor of the facial nerve. The patient was a 41-year-old man suffering from facial palsy on the right side once in 1983, which recurred in 1988. The initial facial palsy was cured after conservative treatments including steroid administration. Three months after the recurrence, the same treatments were attempted without noticeable effect. He was referred to our clinic two and half months later. Electromyographic examination indicated pronounced denervation of the facial nerve. Imaging study including high resolution CT and MRI revealed a mass lesion around the geniculate ganglion. Facial neuroma was initially suspected. Surgical exploration revealed a tumor involving the geniculate ganglion and the horizontal portion of the facial nerve. The tumor was resected through a combined transmastoid and middle cranial fossa approach, followed by nerve grafting. Histologically, the tumor proved to be an inflammatory pseudotumor originating from the nerve sheath, although the etiologic factor causing the inflammation was not verified.
这是一篇关于一例因面神经炎性假瘤导致复发性面瘫病例的报告。患者为一名41岁男性，1983年曾患右侧面瘫，1988年复发。首次面瘫经包括使用类固醇在内的保守治疗后治愈。复发三个月后，尝试同样的治疗方法但无明显效果。两个半月后他被转诊至我院。肌电图检查显示面神经有明显的失神经支配。包括高分辨率CT和MRI在内的影像学检查发现膝状神经节周围有一肿块病变。最初怀疑为面神经瘤。手术探查发现肿瘤累及膝状神经节和面神经水平段。通过经乳突和中颅窝联合入路切除肿瘤，随后进行神经移植。组织学检查证实肿瘤为起源于神经鞘的炎性假瘤，尽管引起炎症的病因未得到证实。
