Noguchi Yoshihiro, Takahashi Masatoki, Momiyama Naoko, Sugimoto Tarou, Kitamura Ken
Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 2012 Jul;115(7):687-92. doi: 10.3950/jibiinkoka.115.687.
Intralabyrinthine schwannomas (ILSs) are rare benign neoplasms arising from distal branches of the cochlear, superior vestibular, or inferior vestibular nerves. We report on a case of ILS with extensions to the round window niche and internal auditory canal (IAC) in a 47-year-old male. The patient noticed sudden hearing loss and tinnitus in his left ear at the age of 36, received steroid therapies, but was left with complete deafness. He had suffered from repetitive vertigo attacks for 6 months at 41. At 46 when he presented with deterioration of his left tinnitus, he was finally diagnosed as having ILS on enhanced MRI and constructive interference in steady-state analysis. The tumor was located in all turns of cochlea, vestibule, and the fundus of the IAC. Because follow-up MRI suggested growth of the IAC tumor, we performed total removal of the tumor via the translabyrinthine and transcanal approaches. The tumor had invaded only the cochlear nerve in the IAC and appeared in the round window niche in the middle ear. Pathological examination showed an Antoni A type schwannoma with fibrous changes of the semicircular canals. We should remember this inner
迷路内神经鞘瘤（ILSs）是起源于耳蜗、前庭上或前庭下神经远端分支的罕见良性肿瘤。我们报告一例47岁男性ILS延伸至圆窗龛和内耳道（IAC）的病例。患者36岁时左耳突发听力丧失和耳鸣，接受了类固醇治疗，但仍完全失聪。他41岁时曾反复眩晕发作6个月。46岁时，当他出现左耳耳鸣加重时，最终通过增强磁共振成像和稳态构成干扰分析被诊断为ILS。肿瘤位于耳蜗各圈、前庭和IAC底部。由于随访磁共振成像显示IAC肿瘤生长，我们通过迷路和经耳道入路对肿瘤进行了全切除。肿瘤仅侵犯了IAC内的耳蜗神经，并出现在中耳的圆窗龛。病理检查显示为Antoni A型神经鞘瘤，半规管有纤维改变。我们应该记住这个内耳的……（原文此处不完整）
