Roche P H, Figarella-Branger D, Malca S, Soumare O, Pellet W
Service de Neurochirurgie, Hôpital Sainte-Marguerite, Marseille.
Neurochirurgie. 1997;43(3):148-53.
Acousticofacial cavernomas are rare lesions. Only 4 cases with a cerebellopontine extension have been reported previously whereas intrapetrous facial nerve cavernomas are well described in the otologic literature. In this paper, we describe two additional cases of acousticofacial cavernomas.
The two patients were operated via a translabyrinthine route with a preoperative diagnosis of vestibular schwannoma. In the first case, the lesion was confined in the internal auditory canal whereas the cavernoma extended into the cerebellopontine angle in the latter.
Diagnosis is suspected when facial nerve deficit strikingly reveals a small cerebellopontine angle lesion. MRI examination is not specific enough when the lesion is confined to the internal auditory canal. Treatment is based upon surgical removal although facial nerve impairment is often described as the main cause of postoperative morbidity.
听面海绵状血管瘤是罕见病变。此前仅报道过4例伴有桥小脑角延伸的病例,而岩骨内面神经海绵状血管瘤在耳科学文献中有详尽描述。在本文中,我们描述另外两例听面海绵状血管瘤病例。
两名患者术前诊断为前庭神经鞘瘤,经迷路入路进行手术。第一例中,病变局限于内耳道,而在后一例中,海绵状血管瘤延伸至桥小脑角。
当面神经功能缺损显著提示桥小脑角有小病变时应怀疑诊断。当病变局限于内耳道时,MRI检查特异性不足。治疗基于手术切除,尽管面神经损伤常被描述为术后发病的主要原因。