Symon L, Cheesman A D, Kawauchi M, Bordi L
Gough-Cooper Department of Neurological Surgery, National Hospital for Neurology and Neurosurgery, London, UK.
Br J Neurosurg. 1993;7(1):13-22. doi: 10.3109/02688699308995051.
Twelve patients with facial nerve neurinoma have been treated at The National Hospital, Queen Square, London, during the last 20 years. Nine tumours lay in the middle fossa arising from the area of the geniculate ganglion, two lay in the posterior fossa arising from the segment of the facial nerve in the internal auditory canal, and one tumour arose from the vertical segment of the facial nerve with extracranial extension through the stylomastoid foramen. Two patients had neurofibromatosis. The clinical and radiographic features of those tumours, the operative approaches employed, and the postoperative outcome are described. Complete tumour excision was achieved in all patients; all 12 remain free of recurrence 3-80 months after surgery. Facial nerve function was restored at least in part in all cases by transposition with end-to-end anastomosis, placement of a cable graft from the sural nerve or hypoglosso-facial anastomosis. The major determinant of the outcome of facial nerve function was the duration of preoperative facial paralysis, the results being invariably poor when this was of long duration.
在过去20年中，伦敦女王广场国立医院共治疗了12例面神经神经鞘瘤患者。9例肿瘤位于中颅窝，起源于膝状神经节区域；2例位于后颅窝，起源于内耳道内的面神经段；1例肿瘤起源于面神经垂直段，并经茎乳孔向颅外扩展。2例患者患有神经纤维瘤病。本文描述了这些肿瘤的临床和影像学特征、采用的手术入路以及术后结果。所有患者均实现了肿瘤完全切除；术后3至80个月，所有12例患者均无复发。通过端端吻合移位、腓肠神经电缆移植或舌下-面神经吻合，所有病例的面神经功能至少部分得以恢复。面神经功能恢复结果的主要决定因素是术前面瘫的持续时间，当面瘫持续时间较长时，结果往往较差。
