Hironaka Yasuo, Nakase Hiroyuki, Motoyama Yasushi, Mishima Hideaki, Park Young-Su, Hirabayashi Hidehiro, Sakaki Toshisuke
Department of Neurosurgery, Nara Medical University, Kashihara, Nara.
Neurol Med Chir (Tokyo). 2010;50(2):154-7. doi: 10.2176/nmc.50.154.
A 58-year-old man presented with a rare orbitocavernous sinus schwannoma that originated from the orbital opthalmic nerve, and manifested as slowly progressive hypesthesia of the right side of the forehead, proptosis, and ocular pain with rapidly worsening visual acuity. Magnetic resonance imaging revealed a huge orbital tumor extending to the lateral wall of the cavernous sinus through the superior orbital fissure. Microsurgical total resection of the tumor was achieved using an epidural orbitofrontal approach with orbito-fronto-zygomatic craniotomy. The histological diagnosis was schwannoma with Antoni type A formation. The postoperative course was uneventful except for the hypesthesia on the right side of the forehead and transient oculomotor paralysis. Surgery was effective to relieve the symptoms and improve the activities of daily living.
一名58岁男性患有罕见的起源于眶部视神经的眶海绵窦神经鞘瘤，表现为右侧前额缓慢进展的感觉减退、眼球突出和眼痛，视力迅速恶化。磁共振成像显示一个巨大的眼眶肿瘤通过眶上裂延伸至海绵窦外侧壁。采用硬膜外眶额入路联合眶-额-颧开颅术对肿瘤进行了显微外科全切除。组织学诊断为具有Antoni A型结构的神经鞘瘤。术后除右侧前额感觉减退和短暂动眼神经麻痹外，病程平稳。手术有效缓解了症状并改善了日常生活活动能力。
