Han Yu, Liu Hongsheng, Yang Runqin, Li Rui, Liu Xiaoxiao, Wang Wenyue, Zhang Jiayi, Dong Jiping, Zha Dingjun
Department of Otolaryngology，Xijing Hospital，Air Force Medical University，Xi'an，710032，China.
National Clinical Research Center for Otolaryngologic Diseases of Shaanxi Sub Center.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 May;38(5):380-385. doi: 10.13201/j.issn.2096-7993.2024.05.006.
To explore the clinical manifestations and imaging characteristics, and to clarify the imaging value in the diagnosis of facial nerve schwannomas. Retrospectively analyze the data of 23 patients with facial nerve schwannomas confirmed by surgery and pathology in the Department of Otorhinolaryngology of the First Affiliated Hospital of the Air Force Military Medical University from September 2020 to September 2022, including 8 males and 15 females, aged 18-66 years old. Summarize and analyze their clinical symptoms, specialized examinations, and imaging findings. The clinical manifestations were facial nerve paralysis in 15 cases（2 cases of HB Ⅳ, 6 cases of HB Ⅴ, 7 cases of HB Ⅵ）, hearing loss in 14 cases（5 cases of conductive deafness, 2 cases of mixed deafness, and 7 cases of severe sensorineural hearing loss）, 8 cases tinnitus, 7 cases ear pain, 4 cases dizziness, 4 cases headache, 2 cases ear pus, and parotid gland tumors in 6 cases presenting as local masses. Endoscopic examination revealed 8 cases of external ear canal tumors and 3 cases of intratympanic tumors. Combining temporal bone HRCT, MRI enhanced scanning, and CPR imaging techniques, 1 case involved the internal auditory canal segment, 2 cases in the tympanic segment, 6 cases in the parotid gland area. A total of 14 cases involved two or more segments of the internal auditory canal segment, the labyrinthine segment, geniculate ganglion, the tympanic segment, and the mastoid segment. When the tumors were large, adjacent structures were involved. It was found that 8 cases invaded the external auditory canal and tympanic cavity, ossicles were displaced or bony destruction; 3 cases invaded the jugular foramen area, and 1 case grew to the middle cranial fossa region with temporal lobe brain parenchymal compression. The clinical manifestations of facial nerve schwannomas are diverse. The combination of various imaging techniques will be conducive to topical and qualitative diagnosis and provide an important basis for treatment strategies.
探讨面神经鞘瘤的临床表现及影像学特征，阐明其在面神经鞘瘤诊断中的影像学价值。回顾性分析2020年9月至2022年9月空军军医大学第一附属医院耳鼻咽喉科收治的23例经手术及病理证实的面神经鞘瘤患者资料，其中男8例，女15例，年龄18～66岁。总结分析其临床症状、专科检查及影像学表现。临床表现为面神经麻痹15例（House-Brackmann分级Ⅳ级2例、Ⅴ级6例、Ⅵ级7例），听力下降14例（传导性聋5例、混合性聋2例、重度感音神经性聋7例），耳鸣8例，耳痛7例，头晕4例，头痛4例，耳流脓2例，6例腮腺区肿瘤表现为局部肿块。内镜检查发现外耳道肿物8例，鼓室内肿物3例。结合颞骨高分辨率CT、MRI增强扫描及CPR成像技术，内听道段受累1例，鼓室段2例，腮腺区6例。共14例累及内听道段、迷路段、膝状神经节、鼓室段及乳突段中的两个或以上节段。肿瘤较大时可累及相邻结构，发现8例侵犯外耳道及鼓室，听小骨移位或骨质破坏；3例侵犯颈静脉孔区，1例生长至中颅窝区域压迫颞叶脑实质。面神经鞘瘤临床表现多样，多种影像学技术联合有助于定位及定性诊断，为治疗策略提供重要依据。
