Hyakusoku Hiroshi, Tanaka Yoshihide, Tsuchiya Yusuke, Nakayama Meijin
Departments of1Otorhinolaryngology and.
2Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka City, Kanagawa, Japan.
J Neurosurg Case Lessons. 2023 May 29;5(22). doi: 10.3171/CASE23141.
Cavernous hemangioma of the internal auditory canal is extremely rare and is characterized by symptoms such as vertigo, sensorineural hearing loss, and facial nerve dysfunction.
A health examination on an 11-year-old female in the fifth grade revealed hearing loss in the left ear. She also had dizziness that had persisted for approximately 1 year. Pure-tone audiometry revealed sensorineural hearing loss in her left ear. Rightward horizontal and rotatory nystagmus was detected. Facial paralysis was not present. Magnetic resonance imaging showed a lesion that was suspected to be hemangioma. The authors selected a left suboccipital retrosigmoid approach. The tumor showed a berry-tufted appearance throughout the cerebellopontine angle. The seventh cranial nerve penetrated the tumor and partly circulated outside the tumor with marked adhesion. The authors partially resected the tumor to avoid damaging the facial nerve. A histological examination identified cavernous hemangioma.
The fundamental treatment for cavernous hemangioma of the internal auditory canal is complete surgical removal; however, any surgical intervention may result in hearing loss and facial paralysis. The extent of surgery needs to be decided intraoperatively based on the balance between preoperative symptoms and postoperative complications.
内耳道海绵状血管瘤极为罕见，其特征为眩晕、感音神经性听力损失及面神经功能障碍等症状。
对一名五年级11岁女性进行的健康检查发现左耳听力损失。她还伴有持续约1年的头晕。纯音听力测试显示左耳感音神经性听力损失。检测到向右的水平和旋转性眼球震颤。未出现面瘫。磁共振成像显示有一个疑似血管瘤的病变。作者选择了左枕下乙状窦后入路。肿瘤在整个桥小脑角呈现出莓状丛生外观。第七颅神经穿过肿瘤并部分在肿瘤外环绕，有明显粘连。作者部分切除肿瘤以避免损伤面神经。组织学检查确诊为海绵状血管瘤。
内耳道海绵状血管瘤的根本治疗方法是完全手术切除；然而，任何手术干预都可能导致听力损失和面瘫。手术范围需要在术中根据术前症状和术后并发症之间的平衡来决定。
