Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, China.
Department of Otorhinolaryngology Head and Neck Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Ear Nose Throat J. 2023 May;102(5):297-300. doi: 10.1177/01455613211000292. Epub 2021 Mar 18.
Facial nerve schwannoma (FNS) is a benign, slow-growing schwannoma that originates from Schwann cells. Facial nerve schwannoma is the most common tumor of the facial nerve but rare and only accounts for 0.15% to 0.8% of intracranial neurinomas. It may be manifested as asymmetric hearing loss, facial palsy, and hemifacial spasm. A 56-year-old woman was transferred to our department, because of pain behind the right ear and spasm of the right lateral muscle for more than 2 years and pulsatile tinnitus for half a year. Based on the preoperative medical history, physical signs, and auxiliary examination, it was diagnosed with jugular foramen (JF) space-occupying lesion. We removed the tumor through the infratemporal fossa type A approach and found that the tumor originated from the facial nerve. After the tumor resection, sural nerve transplantation was performed. The patient demonstrated postoperative facial palsy (House-Brackman grade VI) and was smoothly discharged after good recovery. Facial nerve schwannoma rarely invades the JF, and the most common tumor in the JF is the glomus jugular tumor, followed by the posterior cranial schwannoma. They have common symptoms, making it difficult to obtain a correct diagnosis. Clinical data, medical history, and auxiliary examinations should be carefully analyzed to avoid misdiagnosis or mistreatment. Infratemporal fossa type A approach is an effective method for treating FNS of JF.
面神经鞘瘤（Facial nerve schwannoma，FNS）是一种起源于施万细胞的良性、生长缓慢的鞘瘤。面神经鞘瘤是面神经最常见的肿瘤，但罕见，仅占颅内神经鞘瘤的 0.15%至 0.8%。它可能表现为不对称性听力损失、面瘫和半侧面肌痉挛。一名 56 岁女性因右耳后疼痛伴右侧外肌痉挛 2 年余、搏动性耳鸣半年就诊于我科。根据术前病史、体征及辅助检查，诊断为颈静脉孔（jugular foramen，JF）占位性病变。我们经颞下窝 A 型入路切除肿瘤，发现肿瘤起源于面神经。肿瘤切除后，进行腓肠神经移植。术后患者出现面瘫（House-Brackman 分级 VI 级），经良好恢复后顺利出院。面神经鞘瘤很少侵犯 JF，JF 最常见的肿瘤是颈静脉球体瘤，其次是后颅窝神经鞘瘤。它们有共同的症状，导致难以获得正确的诊断。应仔细分析临床资料、病史和辅助检查，以避免误诊或误治。颞下窝 A 型入路是治疗 JF 面神经鞘瘤的有效方法。
