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[牙痛:在什么情况下需要考虑桥小脑角肿瘤?]

[Toothache: At what point has a pontocerebellar angle tumor to be evoked?].

作者信息

Imholz B, Lombardi T, Scolozzi P

机构信息

Unité de médecine et de pathologie orale, service de chirurgie maxillo-faciale et de chirurgie buccale, département de chirurgie, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, CH-1211 Genève 14, Suisse.

Unité de médecine et de pathologie orale, service de chirurgie maxillo-faciale et de chirurgie buccale, département de chirurgie, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, CH-1211 Genève 14, Suisse.

出版信息

Rev Stomatol Chir Maxillofac Chir Orale. 2015 Jun;116(3):161-5. doi: 10.1016/j.revsto.2015.04.002. Epub 2015 May 20.

Abstract

INTRODUCTION

Dental pain may have another origin than teeth. It may be caused by myofascial, neurovascular, cardiac, neurological, sinusal or psychological factors. We will discuss 2 rare cases of patients who presented with a cerebellopontine tumor, who initially manifested with symptoms of dental pain.

OBSERVATION

The first patient, male, 44 years of age presented to his dentist with toothache (47), which led to its extraction. Five months later, a second painful episode, more characteristic, revealed the presence of a vestibular schwannoma, which was successfully treated and led to the disappearance of the pain. The second case, a 43-year-old female presented to her dentist with toothache (46), which lead the dentist perform a root filling. Two years later, with a 3rd episode of dental pain, more relevant of a trigeminal neuralgia, a epidermoid cyst of the right cerebellopontine angle was identified and successfully treated leading to the disappearance of the pain.

DISCUSSION

Cerebellopontine tumors of this type may lead, in exceptional cases to symptoms of dental pain. Therefore, in face of atypical tooth or facial pain, both a detailed medical history and a detailed examination are necessary, in order to investigate any neurological signs and symptoms, before undertaking any non-essential dental treatment, which may be detrimental for the patients.

摘要

引言

牙痛的根源可能并非牙齿本身。它可能由肌筋膜、神经血管、心脏、神经、鼻窦或心理因素引起。我们将讨论2例罕见病例,患者最初表现为牙痛,最终被诊断为桥小脑角肿瘤。

病例

首例患者为44岁男性,因牙痛(47)前往牙医处就诊,随后该牙被拔除。五个月后,第二次疼痛发作,症状更具特征性,最终确诊为前庭神经鞘瘤,经成功治疗后疼痛消失。第二例患者为43岁女性,因牙痛(46)前往牙医处就诊,牙医进行了根管充填治疗。两年后,第三次牙痛发作,更符合三叉神经痛的症状,最终确诊为右侧桥小脑角表皮样囊肿,经成功治疗后疼痛消失。

讨论

这种类型的桥小脑角肿瘤在极少数情况下可能导致牙痛症状。因此,面对非典型的牙齿或面部疼痛,在进行任何可能对患者有害的非必要牙科治疗之前,详细的病史和详细的检查都是必要的,以便排查任何神经体征和症状。

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