Choi Mi Sun, Kim Young Im, Ahn Young Hwan
Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
J Korean Neurosurg Soc. 2014 Aug;56(2):149-51. doi: 10.3340/jkns.2014.56.2.149. Epub 2014 Aug 31.
The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass (2×3×3 mm in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only microvascular decompression of the offending PICA was performed. Additional procedure was not performed. Her severe lancinating pain remained unchanged, immediate postoperatively. The neuralgic pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing glossopharyngeal neuralgia, microvascular decompression of offending vessel alone was enough to control the neuralgic pain.
导致三叉神经痛或半面痉挛的桥小脑角脂肪瘤很罕见。导致舌咽神经痛的脂肪瘤也极为罕见。一名46岁女性主诉有2年严重右咽痛病史，伴有同侧发作性耳痛。咽痛被描述为局限于咽喉的发作性刺痛。计算机断层扫描和磁共振成像显示，可疑的责任血管为后下小脑动脉（PICA），它压迫包括舌咽神经在内的低位颅神经。手术中，发现一个柔软的黄色肿物（大小为2×3×3毫米），包绕着第9和第10颅神经近端的外侧。仅对责任PICA进行了微血管减压。未进行其他操作。术后即刻，她的严重刺痛疼痛未变。数周内，神经痛消失。在这名由脂肪性神经血管肿块导致舌咽神经痛的特殊患者中，仅对责任血管进行微血管减压就足以控制神经痛。
