Fukui S, Miyazawa T, Okawa H, Ishihara S, Terahata S, Tamai S, Shima K, Chigasaki H
Department of Neurosurgery, National Defense Medical College, Saitama, Japan.
No Shinkei Geka. 1997 Jan;25(1):47-51.
A 39-year-old man was admitted with right hearing loss, tinnitus and vertigo. Neurological examination on admission revealed right facial palsy, right acoustic nerve disturbance and cerebellar ataxia. CT scan demonstrated a mass with intra-and extracranial extension in the pyramid bone concomitant with enlarged jugular foramen. MRI showed a ring-like enhanced, extra-axial mass in the right CP angle. Cerebral angiography showed no tumor stain. Venous phase of VAG revealed lateral displacement of the right sigmoidal sinus and obstruction of the internal jugular vein. Three dimensional CT was very useful to reveal enlarged jugular foramen. The tumor was resected totally and was approached through a right suboccipital craniectomy and mastoidectomy on July, 1994. Surgery confirmed that the tumor was a neurinoma originating from the glossopharyngeal nerve. After the operation, right facial palsy developed and transient fugitive CSF leakage was observed, but the patient is doing well. There was no amelioration of right hearing loss. JFN originating from the glossopharyngeal nerve is rare. Twenty-five cases of glossopharyngeal neurinoma are reviewed.
一名39岁男性因右耳听力丧失、耳鸣和眩晕入院。入院时神经系统检查发现右侧面神经麻痹、右侧听神经功能障碍和小脑共济失调。CT扫描显示颞骨内有一肿块，向颅内和颅外扩展，同时颈静脉孔扩大。MRI显示右侧小脑脑桥角有一个环形强化的轴外肿块。脑血管造影未显示肿瘤染色。VAG静脉期显示右侧乙状窦外侧移位和颈内静脉阻塞。三维CT对显示扩大的颈静脉孔非常有用。1994年7月，通过右枕下颅骨切除术和乳突切除术对肿瘤进行了全切。手术证实肿瘤是起源于舌咽神经的神经鞘瘤。术后出现右侧面神经麻痹，并观察到短暂的脑脊液漏，但患者恢复良好。右耳听力丧失没有改善。起源于舌咽神经的颈静脉孔神经鞘瘤很罕见。本文回顾了25例舌咽神经鞘瘤病例。
