Lim Chee Chean, Misron Khairunnisak, Liew Yew Toong, Wong Eugene Hung Chih
Department of Otorhinolaryngology-Head and Neck Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Otorhinolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia.
BMJ Case Rep. 2019 Nov 4;12(11):e232275. doi: 10.1136/bcr-2019-232275.
Acoustic neuroma (AN) usually manifests with asymmetric hearing loss, tinnitus, dizziness and sense of disequilibrium. About 10% of patients complain of atypical symptoms, which include facial numbness or pain and sudden onset of hearing loss. Patients with atypical symptoms also tend to have larger tumours due to the delay in investigation. We report a particularly interesting case of a patient presented to us with numbness over her right hemifacial region after a dental procedure without significant acoustic and vestibular symptoms. Physical examination and pure tone audiometry revealed no significant findings but further imaging revealed a cerebellopontine angle mass. The changing trends with easier access to further imaging indicate that the presentation of patients with AN are also changing. Atypical symptoms which are persistent should raise clinical suspicion of this pathology among clinicians.
听神经瘤（AN）通常表现为不对称性听力丧失、耳鸣、头晕和失衡感。约10%的患者主诉有非典型症状，包括面部麻木或疼痛以及听力突然丧失。有非典型症状的患者由于检查延迟，肿瘤往往也较大。我们报告了一例特别有趣的病例，一名患者在牙科手术后出现右侧半面部麻木，无明显听觉和前庭症状。体格检查和纯音听力测定未发现明显异常，但进一步的影像学检查发现桥小脑角有肿物。随着进一步影像学检查更容易获得，其变化趋势表明听神经瘤患者的表现也在发生变化。持续存在的非典型症状应引起临床医生对这种病理情况的怀疑。
