PDF(Pubmed)
Abstract：
Objective:This study aims to provide a comprehensive summary of the pathogenesis, screening modalities, treatment strategies, repair modalities and preliminary results associated with facial nerve tumors. Methods:A retrospective analysis was conducted on the clinical data of 12 patients with facial nerve tumors who were admitted to our department between May 2018 and February 2023. The study population consisted of 5 males and 7 females, with ages ranging from 35 to 90 years. Clinical symptoms observed in these patients included facial nerve palsy, hearing loss, tinnitus, headache, and otalgia, etc. The severity of facial nerve dysfunction was assessed using the House-Brackmann（H-B） facial nerve function classification, with 3 cases classified as grade Ⅰ, 4 cases as grade Ⅲ, 2 cases as grade Ⅳ, and 3 cases as grade Ⅴ. There was a total of 11 patients who presented with hearing loss. Among these patients, 7 cases were diagnosed with conductive hearing loss, 2 cases with sensorineural hearing loss, and 2 cases with mixed hearing loss. The selection of the observation or surgical route for tumor localization was based on clinical symptoms, facial nerve function grading, and imaging examination results including temporal bone CT and enhanced MRI. Specifically, the location of the tumor was selected for observation or the best surgical route: 2 cases were followed up for observation, 1 case underwent biopsy, and 9 cases underwent tumor resection（7 cases of trans-mastoid approach, 2 cases of combined parotid-mastoidal approach）, concurrent repair of the facial nerve（4 cases of auricular nerve grafting, 3 cases of facial nerve diversion anastomosis, 2 cases of peroneal nerve grafting）. （4 cases of auricular nerve graft, 3 cases of facial nerve diversion anastomosis and 2 cases of peroneal nerve grafting）. Periodic postoperative evaluation of facial nerve function was conducted. Results:1-year follow-up was available. Intraoperatively, it was observed that 66.7%（6 out of 9） of the facial nerve tumors were present in multiple segments. Among these segments, the vertical segment had the highest proportion, accounting for 77.8%（7 out of 9）, followed by the labyrinthine segment/geniculate ganglion with 66.7%（6 out of 9） and the horizontal segment with 55.6%（5 out of 9）. Postoperative pathology confirmed 8 cases with nerve sheath meningioma, Ⅰ with seminal fibroma and 1 with hemangioma. Postoperative facial nerve function was graded as H-B grade I in one patient）, grade Ⅲ in three, grade Ⅳ in four, grade Ⅴ in 2, and grade Ⅵ in 2 patients. The auditory outcomes following surgery are as follows: 8 individuals experienced postoperative hearing loss, while 2 individuals demonstrated postoperative hearing preservation. Conclusion:In the case of patients presenting with facial nerve palsy as their initial symptom, it is imperative to consider the potential presence of a facial nerve tumor. To determine the appropriate course of action, it is necessary to ascertain the size and location of the tumors through imaging examinations. This information will aid in the decision making process regarding whether surgical intervention is warranted, and so, the most suitable approach. Additionally, the choice of repair method during the operation should be guided by the extent of facial nerve defect.
目的：总结面神经肿瘤发病特征、检查方式、治疗策略、修复方式及初步效果。 方法：回顾分析2018年5月至2023年2月收治的12例面神经肿瘤患者的临床资料，其中男5例，女7例；年龄35～90岁。临床症状包括面神经麻痹、听力下降、耳鸣、头痛、耳痛等，按House-Brackmann（H-B）面神经功能分级：Ⅰ级3例，Ⅲ级4例，Ⅳ级2例，Ⅴ级3例。听力下降患者11例：传导性聋7例，感音神经性聋2例，混合性聋2例。根据临床症状、面神经功能分级、影像学检查（颞骨CT、增强MRI）结果确定肿瘤所处位置选择观察或最佳手术径路：2例随访观察，1例行肿物活检术，9例切除肿瘤（经乳突入路7例、经腮腺乳突联合入路2例）并同期行修复面神经（耳大神经移植4例、面神经改道吻合3例、腓肠神经移植2例）。术后定期评估面神经功能。 结果：术后随访1年。术中可见66.7％（6/9）面神经肿瘤位于多个节段：垂直段占比最大77.8％（7/9），其次是迷路段/膝状神经节66.7％（6/9）和水平段55.6％（5/9）。病理报告：神经鞘膜瘤8例，神纤维瘤和血管瘤各1例。10例术后患者面神经功能：Ⅰ级1例，Ⅲ级1例，Ⅳ级4例，Ⅴ级2例，Ⅵ级2例。10例术后患者听力情况：8例术后听力下降，2例术后听力保留。 结论：对首发症状为面神经麻痹的患者应考虑面神经肿瘤可能；根据影像学检查明确肿瘤大小、位置选择是否手术及手术方式；术中根据面神经缺损长度选择修复方式。.
目的：总结面神经肿瘤发病特征、检查方式、治疗策略、修复方式及初步效果。 方法：回顾分析2018年5月至2023年2月收治的12例面神经肿瘤患者的临床资料，其中男5例，女7例；年龄35～90岁。临床症状包括面神经麻痹、听力下降、耳鸣、头痛、耳痛等，按House-Brackmann（H-B）面神经功能分级：Ⅰ级3例，Ⅲ级4例，Ⅳ级2例，Ⅴ级3例。听力下降患者11例：传导性聋7例，感音神经性聋2例，混合性聋2例。根据临床症状、面神经功能分级、影像学检查（颞骨CT、增强MRI）结果确定肿瘤所处位置选择观察或最佳手术径路：2例随访观察，1例行肿物活检术，9例切除肿瘤（经乳突入路7例、经腮腺乳突联合入路2例）并同期行修复面神经（耳大神经移植4例、面神经改道吻合3例、腓肠神经移植2例）。术后定期评估面神经功能。 结果：术后随访1年。术中可见66.7％（6/9）面神经肿瘤位于多个节段：垂直段占比最大77.8％（7/9），其次是迷路段/膝状神经节66.7％（6/9）和水平段55.6％（5/9）。病理报告：神经鞘膜瘤8例，神纤维瘤和血管瘤各1例。10例术后患者面神经功能：Ⅰ级1例，Ⅲ级1例，Ⅳ级4例，Ⅴ级2例，Ⅵ级2例。10例术后患者听力情况：8例术后听力下降，2例术后听力保留。 结论：对首发症状为面神经麻痹的患者应考虑面神经肿瘤可能；根据影像学检查明确肿瘤大小、位置选择是否手术及手术方式；术中根据面神经缺损长度选择修复方式。.
摘要：
暂无翻译
