Pelissou I, Sindou M, Haguenauer J P, Confavreux C, Bascoulergues Y
Neurochirurgie. 1987;33(2):148-51.
A case of a 33 year-old woman presenting an intrapetrous facial nerve neurinoma is reported. The neurological finding was a quickly progressive facial nerve palsy without hearing loss which the initial diagnosis was a Bell's palsy. The radiological findings showing an petrous bone erosion located at the third portion of the facial nerve gave the diagnosis. It was confirmed by CT scan and arteriography that allows a pre-operative embolisation. A one stage operation performed by a triple retromastoid, transpetrous and retroparotid approach, allowed a complete removal. The post-operative course was uneventful and a reconstructive facial surgery was performed to restore a facial symmetry six months later. The authors review the literature about this tumor which remains rare and point out two facts: --A non regressive or recurrent or atypical facial nerve palsy had to be checked up by neuroradiology and even by surgical exploration. --The triple retromastoid, transpetrous and retroparotid approach is very interesting, allowing a one stage complete removal of the tumor and a check up of the facial nerve repair possibilities.
报告了一例33岁女性患有岩骨内面神经神经鞘瘤的病例。神经学检查发现为快速进展的面神经麻痹且无听力丧失，最初诊断为贝尔麻痹。影像学检查发现面神经第三段处有岩骨侵蚀，从而得出诊断。通过CT扫描和动脉造影得以证实，这也为术前栓塞提供了可能。采用经乳突后、经岩骨和腮腺后联合入路进行一期手术，实现了肿瘤的完全切除。术后过程顺利，六个月后进行了面部重建手术以恢复面部对称性。作者回顾了关于这种罕见肿瘤的文献，并指出两个事实：——对于非退行性、复发性或非典型性面神经麻痹，必须通过神经放射学检查，甚至进行手术探查。——经乳突后、经岩骨和腮腺后联合入路非常有意义，能够一期完全切除肿瘤并检查面神经修复的可能性。
