Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Department of Otorhinolaryngology, Head and Neck Surgery, University of Zurich, Zurich, Switzerland.
Audiol Neurootol. 2021;26(4):265-272. doi: 10.1159/000511634. Epub 2020 Dec 22.
The aim of this study is to perform a histopathologic analysis of temporal bones with an intralabyrinthine schwannoma (ILS) in order to characterize its extension.
Archival temporal bones with a diagnosis of sporadic schwannoma were identified. Both symptomatic and occult nonoperated ILS were included for further analysis.
A total of 6 ILS were identified, with 4 intracochlear and 2 intravestibular schwannomas. All intracochlear schwannomas involved the osseous spiral lamina, with 2 extending into the modiolus. The intravestibular schwannomas were limited to the vestibule, but growth into the bone next to the crista of the lateral semicircular canal was observed in 1 patient.
Complete removal of an ILS may require partial removal of the modiolus or bone surrounding the crista ampullaris as an ILS may extend into these structures, risking damage of the neuronal structures. Due to the slow growth of the ILS, it remains unclear if a complete resection is required with the risk of destroying neural structures hindering hearing rehabilitation with a cochlear implant.
本研究旨在对具有内淋巴囊神经鞘瘤（ILS）的颞骨进行组织病理学分析，以明确其扩展范围。
确定诊断为散发性神经鞘瘤的存档颞骨。对有症状和无症状未手术的 ILS 均进行进一步分析。
共发现 6 例 ILS，其中 4 例为耳蜗内神经鞘瘤，2 例为前庭内神经鞘瘤。所有耳蜗内神经鞘瘤均累及骨螺旋板，其中 2 例延伸至蜗轴。前庭内神经鞘瘤局限于前庭，但在 1 例患者中观察到生长至外侧半规管嵴旁的骨内。
ILS 的完全切除可能需要部分切除蜗轴或鼓岬周围的骨，因为 ILS 可能延伸至这些结构，有损伤神经元结构的风险。由于 ILS 生长缓慢，尚不清楚是否需要完全切除，以避免破坏神经结构，从而阻碍使用人工耳蜗进行听力康复。
