摘要
目的提高面神经瘤诊断率和治疗效果。方法1993-2004年我院手术治疗的18例面神经瘤患者，术前均行CT或MRI检查，术后随访6月～5年（平均为40月），面神经功能评估采用House-Brackman（H-B）系统。结果14例患者主诉为面瘫，听力下降9例，耳道肿块2例，腮腺肿块2例。影像学检查发现肿瘤位于面神经的内听道至腮腺区。术中有12例可见肿瘤涉及面神经的多个部位，其中2例可见肿瘤呈串珠状分布于面神经的内听道段至腮腺区。术后病理诊断为：14例面神经鞘瘤，3例面神经纤维瘤，1例面神经血管瘤。7例行面神经移植的患者中2例术后面神经功能达到H-B3级，其余5例术后为H-B4级。面神经端端吻合患者术后面神经功能为H-B4级。2例行单纯面神经瘤切除患者术后面神经功能分别为H-B2和H-B3级。1例行面神经减压术患者术后面神经功能为H-B1级。结论面神经瘤的临床表现各异，可涉及面神经的多个部位。术后面神经的功能同手术方式、术前面神经功能有关。
Purpose To improve the diagnosis and management of facial nerve tumor. Methods Eighteen patients with facial nerve tumor were retrospectively analyzed during 1993 - 2004. All patients were undergone either CT scan or MRI, or both. The period of follow-up varies from 6 months to 5 years （average 40 months）. Facial nerve function was evaluated with House-Brackman（H-B） grading system. Results Totally 14 cases complained of facial paralysis, 9 presented with hearing loss, 2 seeked for medical care due to mass in external auditory canal, and 2 had mass in parotid gland. Image studies revealed mass located along the facial nerve course from the parotid gland to internal auditory meatus. Intraoperative findings showed mass involved in internal auditory meatus to parotid gland. Furthermore, mass involved in multiple segment of facial nerve in 12 cases. In 2 cases tumor was pearl-ball cluster along the facial nerve from the internal auditory canal to parotid gland. Postoperative pathological diagnosis demonstrated 14 Schwannoma, 3 neurinoma and 1 case hemangioma. Seven patients were undergone facial nerve graft, 2 recovered to H-B Ⅲ and the other 5 reached H-B Ⅳ, postoperatively. Facial nerve anastomosis was performed on 1 patient, and postoperative outcome was H-B Ⅳ. Two patients underwent tumor resection, while the continuity of facial nerve was preserved; their facial nerve function was H-B Ⅱ and H-B Ⅲ , respectively. One patient operated with facial nerve decompression recovered postoperative facial nerve function to H-B Ⅰ . No facial nerve reconstruction was done on other 7 patients. Conclusions The presentation of facial nerve tumor was various, multiple origins of facial nerve tumor were noted. Postoperative facial nerve function was associated with the surgical procedure and preoperative facial nerve function.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2006年第2期183-186,共4页
Fudan University Journal of Medical Sciences
关键词
面神经
面神经瘤
诊断
手术
facial nerve
facial nerve tumor
diagnosis
surgery
