Department of ENT-HNS, European Institute for Otorhinolaryngology-Head and Neck Surgery and Skull Base Surgery, Sint Augustinus Hospital, GZA, Oosterveldlaan 24, 2600, Antwerp, Belgium.
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2209-2217. doi: 10.1007/s00405-020-05960-6. Epub 2020 Apr 11.
To provide more data on the clinical presentation and natural evolution of facial nerve schwannomas and to provide guidance for therapeutic decision making.
A retrospective case review of eighty patients diagnosed with a facial nerve schwannoma between 1990 and 2018 in ten tertiary referral centers in Europe was performed. Patients' demographics, symptomatology, audiometry, anatomical site (segments involved), size and whenever possible volume measurement were registered.
At presentation, transient or persistent facial palsy was the most common symptom, followed by hearing loss. The schwannoma involved more than one segment in the majority of the patients with the geniculate ganglion being most commonly involved. Initial treatment consisted of a wait and scan approach in 67.5%, surgery in 30% and radiation therapy in 2.5% of the patients. Tympanic segment schwannomas caused mainly conductive hearing loss and were more prone to develop facial palsy at follow-up. Internal auditory canal or cerebellopontine angle schwannomas presented with significantly more sensorineural hearing loss.
Although modern imaging has improved diagnosis of this tumor, choosing the best treatment modality remains a real challenge. Based on the literature review and current findings, more insights into the clinical course and the management of facial nerve schwannomas are provided.
提供更多关于面神经神经鞘瘤临床表现和自然演变的数据，并为治疗决策提供指导。
对 1990 年至 2018 年间在欧洲十个三级转诊中心诊断为面神经神经鞘瘤的 80 例患者进行回顾性病例回顾。记录患者的人口统计学资料、症状、听力测试、解剖部位（受累节段）、大小，如有可能，还记录体积测量结果。
在就诊时，最常见的症状是暂时性或持续性面瘫，其次是听力损失。大多数患者的神经鞘瘤累及多个节段，其中膝状神经节最常受累。初始治疗包括 67.5%的患者等待和扫描、30%的患者手术和 2.5%的患者放疗。鼓室段神经鞘瘤主要引起传导性听力损失，在随访中更易发生面瘫。内听道或桥小脑角神经鞘瘤表现出更显著的感音神经性听力损失。
尽管现代影像学提高了对这种肿瘤的诊断，但选择最佳的治疗方式仍然是一个真正的挑战。基于文献回顾和当前的发现，对面神经神经鞘瘤的临床过程和管理提供了更多的见解。
