Bahuleyan Biji, Patel Vineetkumar Thakorbhai, Anto Mariette, Hessel Sarah E, Ramesh Rochan K, Girish K M, Thomas Santhosh George
Department of Neurosurgery, Lisie Hospital, Ernakulam, Kerala, India.
Department of Neurosurgery, KIMS Hospital, Thiruvananthapuram, Kerala, India.
Surg Neurol Int. 2024 Sep 27;15:345. doi: 10.25259/SNI_586_2024. eCollection 2024.
Posterior location of the facial nerve in relation to vestibular schwannoma (VS) is extremely rare.
An elderly man presented with the right cerebellopontine angle (CPA) syndrome. Magnetic resonance imaging showed the partly cystic and partly solid right CPA lesion extending to the internal auditory meatus. Seventh nerve monitoring showed the facial nerve on the posterior surface of the tumor. At surgery, the facial nerve was seen on the posterior surface of the tumor under the microscope. Partial excision of the tumor was done with preservation of the facial nerve both anatomically and electrophysiologically.
The posterior location of the facial nerve should be anticipated in all patients with VS. The surgical strategy must be altered appropriately to preserve the facial nerve.
面神经相对于前庭神经鞘瘤（VS）位于后方的情况极为罕见。
一名老年男性出现右侧小脑脑桥角（CPA）综合征。磁共振成像显示右侧CPA处有部分囊性和部分实性病变，延伸至内耳道。面神经监测显示面神经位于肿瘤后表面。手术中，在显微镜下可见面神经位于肿瘤后表面。在解剖学和电生理学上均保留面神经的情况下对肿瘤进行了部分切除。
所有VS患者均应考虑面神经位于后方的可能性。必须适当调整手术策略以保留面神经。
