Brozek-Madry Eliza, Niemczyk Kazimierz, Morawski Krzysztof
Klinika Otolaryngologii Warszawskiego Uniwersytetu Medycznego, KN.
Otolaryngol Pol. 2009 Sep-Oct;63(5):437-41. doi: 10.1016/S0030-6657(09)70157-X.
Presenting and discussing the patient with intravestibular schwannoma of the vestibulocochlear nerve, the course of disease, audiologic and radiologic examination and treatment possibilities.
Analysis of clinical presentation and treatment of the patient with intravestibular schwannoma and review of available literature on intralabyrinthine schwannomas.
A 34-year-old male was diagnosed with a tumor localized in the left vestibule and semicircular canals without accompanying vertigo at any time of the disease but with tinnitus and total deafness of the left ear. Preoperative diagnosis was established on the basis of MRI with contrast. Localization of the tumor laterally to the fundus of internal auditory canal was essential for the diagnosis. Surgical treatment was chosen via translabyrinthine approach. Postoperative course was uneventful.
Intralabyrinthine schwannoma are rare pathology. Their occurrence implies that schwannomas can originate at any segment of vestibulocochlear nerve. Most commonly intralabyrinthine schwannomas are observed at intracochlear or intravestibular localization. Present trials of these tumors classification were presented. The symptoms emerging in the course of disease are hearing loss, tinnitus, and vertigo, thus there were described patients with intralabyrinthine schwannomas diagnosed and treated as Meniere disease. Treatment depends on the intensity of symptoms and tumor expansion, while approach is dependant on its localization.
Elaborate radiologic examination including MRI with contrast is essential in case of atypical course of disease with hearing loss, tinnitus and vertigo, or with early diagnosis of Meniere disease.
介绍并讨论患有前庭蜗神经内听道神经鞘瘤的患者、疾病进程、听力学和放射学检查以及治疗方案。
分析内听道神经鞘瘤患者的临床表现及治疗情况,并回顾有关迷路内神经鞘瘤的现有文献。
一名34岁男性被诊断出肿瘤位于左前庭和半规管,在疾病的任何阶段均无伴随眩晕,但有耳鸣和左耳全聋。术前诊断基于增强磁共振成像(MRI)。肿瘤位于内耳道底部外侧对诊断至关重要。选择经迷路入路进行手术治疗。术后病程平稳。
迷路内神经鞘瘤是一种罕见的病理情况。它们的出现意味着神经鞘瘤可起源于前庭蜗神经的任何节段。最常见的迷路内神经鞘瘤见于耳蜗内或前庭内定位。介绍了目前对这些肿瘤的分类尝试。疾病过程中出现的症状包括听力损失、耳鸣和眩晕,因此有患者被诊断为迷路内神经鞘瘤并被当作梅尼埃病进行治疗。治疗取决于症状的严重程度和肿瘤的扩展情况,而手术入路则取决于其定位。
对于出现听力损失、耳鸣和眩晕的非典型病程或早期诊断为梅尼埃病的情况,包括增强MRI在内详尽的放射学检查至关重要。