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[脑肿瘤患者角膜敏感性的变化。使用Draeger触觉测量仪对颅底脑膜瘤及三叉神经和前庭蜗神经神经鞘瘤患者的研究]

[Changes in the sensitivity of the cornea in patients with intracerebral tumors. Studies of patients with meningioma of the cranial base and neurinoma of the trigeminal nerve and the vestibulocochlear nerve using the Draeger esthesiometer].

作者信息

Heller H, Koniszewski G

机构信息

Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg.

出版信息

Klin Monbl Augenheilkd. 1988 Oct;193(4):356-9. doi: 10.1055/s-2008-1050269.

Abstract

The center of the cornea was measured preoperatively in 29 patients suffering from intracranial tumors (acoustic neuroma, trigeminus neuroma, basal meningioma). These measurements were made with the Draeger electronic-optical esthesiometer; the results were supplemented by an analysis of tumor diameters determined by computer tomography. In each case one-half of the patients with acoustic neuromas and medial meningiomas of the wing of the sphenoid bone manifested a reduction in sensitivity at the center of the ipsilateral cornea (normal: 0.8 to 1.7 x 10(-5) N). The diameters of the sensitivity-reducing acoustic neuromas ranged from 15 mm to 45 mm. It may be deduced both from the topographic conditions at the skull base in the vicinity of the porus acusticus internus and from the conditions associated with a pressure-induced lesion of a peripheral nerve that medial acoustic neuromas as small as 10.1 mm in diameter can lead to a reduction in the conductivity of the ipsilateral trigeminal nerve. Only when they attain a diameter of 28.4 mm and when the proportions of the skull base are equally spacious do the acoustic neuromas regularly cause an ipsilateral corneal hypesthesia.

摘要

对29例颅内肿瘤(听神经瘤、三叉神经瘤、基底脑膜瘤)患者在术前测量了角膜中心。这些测量使用了Draeger电子光学感觉计;结果通过对计算机断层扫描测定的肿瘤直径分析进行补充。在每种情况下,一半患有听神经瘤和蝶骨翼内侧脑膜瘤的患者同侧角膜中心敏感性降低(正常:0.8至1.7×10⁻⁵N)。导致敏感性降低的听神经瘤直径范围为15毫米至45毫米。从内耳道附近颅底的地形条件以及与周围神经压力性损伤相关的条件可以推断,直径小至10.1毫米的内侧听神经瘤可导致同侧三叉神经传导性降低。只有当听神经瘤直径达到28.4毫米且颅底比例同样宽敞时,才会经常导致同侧角膜感觉减退。

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