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三叉神经鞘瘤切除术后咽鼓管去神经支配与听力损失

Denervation of the Eustachian Tube and Hearing Loss Following Trigeminal Schwannoma Resection.

作者信息

Ito Christopher J, Malone Alexander K, Wong Ricky H, van Loveren Harry R, Boyev K Paul

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, Florida, United States.

Skull Base and Pituitary Surgery, NorthShore University Health System, Evanston, Illinois, United States.

出版信息

J Neurol Surg Rep. 2016 Mar;77(1):e56-61. doi: 10.1055/s-0035-1570389.

Abstract

Objectives To discuss eustachian tube dysfunction (ETD) as a cause of hearing loss and to discuss its pathogenesis following resection of trigeminal schwannomas. Methods Presented herein are two cases of trigeminal schwannoma that were resected surgically with sacrifice of the motor branch of the trigeminal nerve. Neither of the cases had evidence of extracranial extension nor preoperative ETD. Both patients developed ETD and have been followed without evidence of schwannoma recurrence. Conclusions Trigeminal schwannomas are rare tumors that typically require surgical resection. Hearing loss is a potential postsurgical deficit and warrants evaluation by an otolaryngologist with consideration given to a preoperative audiogram. ETD as a result of trigeminal motor branch sacrifice should be included in the differential diagnosis of postoperative hearing loss in this patient subset as it may be reversed with placement of a tympanostomy tube.

摘要

目的

探讨咽鼓管功能障碍(ETD)作为听力损失的一个原因,并讨论三叉神经鞘瘤切除术后其发病机制。方法:本文介绍了两例三叉神经鞘瘤病例,手术切除肿瘤时牺牲了三叉神经运动支。两例均无颅外扩展证据,术前也无ETD。两名患者均出现了ETD,且在随访过程中均无神经鞘瘤复发迹象。结论:三叉神经鞘瘤是罕见肿瘤,通常需要手术切除。听力损失是潜在的术后缺陷,耳鼻喉科医生应进行评估,并参考术前听力图。对于该患者群体,因牺牲三叉神经运动支导致的ETD应纳入术后听力损失的鉴别诊断,因为放置鼓膜造孔管可能会使其逆转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc1c/4773822/a7dfe9f8d82c/10-1055-s-0035-1570389-i150080-1.jpg

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