摘要
目的探讨原发性面神经瘤的诊断程序与手术治疗方法。方法回顾性分析5例原发性面神经瘤的诊疗经过和术后1～12年的随访结果,包括临床特点、影像学表现及手术治疗经验。结果5例患者中,面神经鞘瘤4例,面神经纤维瘤1例;术前曾误诊为颈静脉球体瘤、中耳癌、耳硬化症、慢性中耳炎各1例。3例经乳突径路,2例经Fisch径路手术;切除肿瘤同时保留全部或部分面神经纤维3例,肿瘤与面神经同时切除2例,面神经与舌下神经吻合1例。随访结果所有病例肿瘤均未复发。3例保留面神经的患者1例面瘫完全恢复,2例获得Ⅰ～Ⅱ级恢复;1例神经吻合获Ⅲ级恢复。结论原发性面神经瘤的早期准确诊断很重要,术中彻底切除肿瘤同时保留面神经或部分神经纤维的效果最为理想,不能保留神经纤维者可行面神经吻合或移植。
Objective To summarize up our experience with procedures of diagnosis and treatment for primary facial nerve tumor. Methods A retrospective study was carried out among 5 cases with primary facial nerve tumor treated in our Hospital, through reviewing their clinical features, image characteristics and the whole course of surgical therapy, including a period of following up lasted for 1 to 12 years after the surgery. Results Among this group of cases, 4 were diagnosed as neurilemmoma and 1 as neurofibroma of facial nerve following the operation, while 4 of them were clinically diagnosed as glomus jugulare tumor, middle ear cancer, otospongiosis and chronic otitis media respectively before surgery. They were all treated by surgery, with 3 cases operated on via mastoid process approach and 2 via Fisch approach. Their tumors were totally removed, with facial nerve fibers remained well in total or partially reserved among 3 cases following the operation, and the segment of nerve totally excised with tumor in the other 2 cases, followed by anastomosis of facial nerve with hypoglossal nerve in one of the latter two during the operation. By the end of following up period, none was found with the tumor reoccurred. Facial paralysis was recovered completely in one and at grade Ⅰ to Ⅱ of facial function in two among the 3 cases with facial nerve reserved totally or partially, while it was recovered to grade Ⅲ in the one with nerve anastomosis. Conclusions It is clinically very important for primary facial nerve tumor to get a correct diagnosis at its early stage, when the tumor can be totally removed with the nerve fibers reserved in whole or in part. For those cases with the nerve impossible to be reserved, facial nerve anastomosis or grafting should be the practicable choice.
出处
《中国中西医结合耳鼻咽喉科杂志》
2007年第2期107-109,共3页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
关键词
面神经瘤
诊断
手术治疗
Facial nerve tumor
Diagnosis
Surgical therapy
