Boutin P, Guth A, Bouccara D, el Garem H, Rey A, Sterkers O
Service d'ORL, Hôpital Beaujon, Faculté X. Bichat, Université Paris 7, Clichy.
Ann Otolaryngol Chir Cervicofac. 1998 Feb;115(1):35-41.
Intralabyrinthine schwannomas are rare tumors of vestibule, cochlea, semicircular canals, or some combination of these three. In the past, they have been found at autopsy or as incidental finding at surgery. Since the advent of magnetic resonance imaging (MRI) with intravenous gadolinium contrast, the preoperative diagnosis is possible. We report two cases of intralabyrinthine schwannoma: one case of intralabyrinthine schwannoma extended into the internal auditory canal (IAC), a second case of tumor restricted to the vestibule. No characteristic clinical presentation of this tumor is reported in the literature. In patients with vestibular weakness (vertigo and no response of caloric testing), MRI with gadolinium contrast can make the diagnosis of intravestibular tumor. In patients with the more common IAC acoustic neuromas, MRI can demonstrate extension of tumor into the labyrinth; diagnosing this extension preoperatively is important to plan surgical treatment.
迷路内神经鞘瘤是一种罕见的肿瘤,起源于前庭、耳蜗、半规管或这三者的某种组合。过去,它们多在尸检时被发现,或在手术中偶然发现。自从引入静脉注射钆对比剂的磁共振成像(MRI)以来,术前诊断成为可能。我们报告两例迷路内神经鞘瘤:一例迷路内神经鞘瘤延伸至内耳道(IAC),另一例肿瘤局限于前庭。文献中未报道该肿瘤的特征性临床表现。对于有前庭功能减退(眩晕且冷热试验无反应)的患者,钆对比剂增强MRI可用于诊断前庭内肿瘤。对于更常见的IAC听神经瘤患者,MRI可显示肿瘤向迷路内的延伸;术前诊断这种延伸对于规划手术治疗很重要。