保留面神经的颞骨内面神经鞘瘤手术  

Intratemporal Facial Nerve Schwannomas: A Facial Nerve-Sparing Stripping Technique

作　　者：韩月臣[1,2,3] 李瑾 孙鹏程[1,2,3] 姜振 樊兆民[1,2,3] 王海波 HAN Yuechen;LI Jin;SUN Pengcheng;JIANG Zhen;FAN Zhaomin;WANG Haibo(Department of Neurotology and lateral skull base Surgery,Shandong Provincial ENT Hospital Affiliated to ShandongUniversity,Jinan 250022,China;Key Laboratory of Otorhinolaryngology,National Health Commission(Shandong University),Jinan 250022,China;Shandong Institute of Otolaryngology,Jinan 250022,China)

机构地区：[1]山东大学附属山东省耳鼻喉医院耳神经-侧颅底外科,济南250022 [2]山东大学国家卫生健康委员会耳鼻喉科学重点实验室,济南250022 [3]山东省耳鼻喉研究所,济南250022

出　　处：《中华耳科学杂志》2019年第4期476-480,共5页Chinese Journal of Otology

摘　　要：目的探讨颞骨内面神经鞘瘤,手术切除肿瘤保留面神经的可能性及其临床特征。方法回顾分析2例保留面神经的颞骨内面神经鞘瘤病例资料,分析其临床表现,影像特点,术中发现及面神经功能预后情况。结果2例患者主要表现为耳部胀痛,听力下降;术前面神经功能正常,均接受手术治疗,术中发现肿瘤位于面神经垂直段及部分颞骨外段,肿瘤包绕神经,剥离肿瘤后神经解剖结构基本得到保存,术中快速冰冻及术后病理均证实为神经鞘瘤。术后面神经功能均为HB-Ⅲ级。结论对于术前没有明显面瘫的颞骨内的面神经鞘瘤,存在手术剥离肿瘤保留神经的可能,且术后面神经功能能很好保留。Objective To report two cases of intratemporal facial nerve schwannoma treated with the nerve-sparingstripping technique and their clinical features.Methods Two patients with the intratemporal facial nerve schwannomareceived facial nerve-sparing stripping surgery and their clinical manifestations,imaging features,intraoperative findingsand postoperative facial nerve function were retrospectively reviewed.Results The two patients presented withmainly otalgia and hearing loss but no facial palsy initially.Intraoperatively,the tumors were found to be located at themastoid segment surrounding the facial nerve.Total tumor removal was successfully achieved using the stripping techniquein both cases and facial nerve continuity was preserved.Intraoperative and postoperative pathology confirmed thetumors as schwannoma.Postoperative facial function in the two patients was House-Brackmann grade Ⅲ.Conclusion Itis possible to preserve the facial nerve continuity using the stripping technique in patients with intratemporal facial nerveschwannoma who have no facial palsy preoperatively.

关 键 词：面神经鞘瘤 手术 颞骨 

分 类 号：R764[医药卫生—耳鼻咽喉科]