Bonfort G, Veillon F, Debry C, Kehrli P, Chibbaro S
Department of ENT, Hautepierre University Hospital, Strasbourg, France; ENT department, Legouest, Instructional Military Hospital, 27, avenue de Plantières, BP 90001, 57077 Metz cedex 3, France.
Department of medical imaging, Hautepierre University Hospital, Strasbourg, France.
Neurochirurgie. 2015 Oct;61(5):352-5. doi: 10.1016/j.neuchi.2015.07.003. Epub 2015 Oct 1.
To report a case of VIIIth nerve cavernous hemangioma, a very rare differential diagnosis among the various pathologies presenting as small enhancing entities into the internal auditory canal. It is one of the most challenging when imaging is not able to differentiate it from an intrameatal vestibular schwannoma.
We report a cavernous hemangioma extruding from the internal auditory canal, diagnosed after a left translabyrinthine resection in a 45-year-old man complaining of profound sensorineural hearing loss, with no facial paresis or dizziness. The preoperative differential diagnosis of a vestibular schwannoma was impossible, due to the absence of calcifications that usually characterize temporal bone hemangiomas. Clinical presentation, radiological features and treatment considerations are discussed along with up-to-date review of pertinent literature.
When considering an apparent small intra-auditory canal schwannoma, otoneurologists should be aware of the rare possibility of a cavernous hemangioma. Early diagnosis and surgical treatment may improve the functional outcome, possibly preserving neural integrity.
报告一例第八颅神经海绵状血管瘤病例，在表现为内耳道内小强化病灶的各种病变中，这是一种非常罕见的鉴别诊断。当影像学无法将其与内耳道内前庭神经鞘瘤区分开来时，这是最具挑战性的情况之一。
我们报告了一例从内耳道突出的海绵状血管瘤，该病例是在一名45岁男性患者接受左迷路后切除术之后确诊的，该患者主诉严重感音神经性听力损失，无面部麻痹或头晕症状。由于缺乏通常为颞骨血管瘤特征的钙化，术前无法鉴别诊断为前庭神经鞘瘤。本文讨论了临床表现、放射学特征和治疗考虑因素，并对相关文献进行了最新综述。
当考虑明显的内耳道内神经鞘瘤时，耳神经科医生应意识到存在海绵状血管瘤这种罕见的可能性。早期诊断和手术治疗可能会改善功能预后，有可能保留神经完整性。
