Komune S, Okada S, Uemura T
Auris Nasus Larynx. 1986;13(3):151-6. doi: 10.1016/s0385-8146(86)80011-6.
The patients with neurilemmomas of the facial nerve within the temporal bone were treated. Although most of cases of the facial nerve neurilemmoma in the temporal bone present with a facial palsy, a few cases have normal facial nerve function and are especially difficult to diagnose preoperatively because of few symptoms. Case 1, a 31-year-old man, developed progressive left facial palsy with protrusion of the posterior wall of the external auditory meatus over a five-month period. Case 2, a 64-year-old man, complained of only fullness and tinnitus of the right ear without any facial nerve symptoms. Polytomography of the temporal bone demonstrated no abnormal findings in both cases. However, computed tomography revealed a soft-tissue density area in the left mastoid cavity with destruction of the posterior wall of the external auditory meatus in case 1. A similar soft-tissue density mass was found in the right tympanic cavity in case 2, suggesting the presence of the tumor in the temporal bone. At operation, the tumors were found to originate from the vertical portion of the facial nerve in both cases. It was assumed that normally existing dehiscences of fallopian canal might account for why some patients have normal facial nerve function.
对颞骨内面神经神经鞘瘤患者进行了治疗。尽管颞骨内面神经神经鞘瘤的大多数病例表现为面瘫，但少数病例面神经功能正常，且由于症状较少，术前诊断特别困难。病例1，一名31岁男性，在五个月的时间里出现渐进性左侧面瘫，外耳道后壁突出。病例2，一名64岁男性，仅主诉右耳胀满和耳鸣，无任何面神经症状。颞骨多层面体层摄影术在两例中均未显示异常发现。然而，计算机断层扫描显示病例1左侧乳突腔内有软组织密度区，外耳道后壁破坏。病例2在右侧鼓室内发现类似的软组织密度肿块，提示颞骨内存在肿瘤。手术时，发现两例肿瘤均起源于面神经垂直段。据推测，正常存在的面神经管裂可能是一些患者面神经功能正常的原因。
