PDF(Pubmed)
Abstract：
BACKGROUND: Eagle syndrome, an uncommon condition, causes symptoms due to neural and/or vascular compression from an elongated styloid process or calcified stylohyoid ligament and can also complicate other planned surgical procedures.
METHODS: A 42-year-old female with loss of balance, dizziness, and ataxic gait underwent cranial magnetic resonance imaging (MRI), revealing a right-sided Koos grade IV vestibular schwannoma. Initially, a retrosigmoid craniotomy for tumor resection was planned. However, preoperative MRI and computed tomography (CT) showed a dilated right-sided mastoid emissary vein, tortuous scalp and paraspinal veins, and bilateral elongated styloid processes. CT angiography and digital subtraction angiography indicated Eagle syndrome-related compression of both internal jugular veins and concurrent occlusion of the left internal jugular vein at the jugular foramen. Consequently, given the risk of damaging venous structures, Gamma Knife radiosurgery was chosen over resection.
CONCLUSIONS: This case highlights the importance of adapting treatment plans based on patient-specific anatomical and pathological factors. In situations in which traditional surgery poses risks to sensitive structures such as the venous system, alternative approaches like radiosurgery offer safer yet effective options. Comprehensive risk-benefit evaluations are crucial for such decisions.
METHODS: A 42-year-old female with loss of balance, dizziness, and ataxic gait underwent cranial magnetic resonance imaging (MRI), revealing a right-sided Koos grade IV vestibular schwannoma. Initially, a retrosigmoid craniotomy for tumor resection was planned. However, preoperative MRI and computed tomography (CT) showed a dilated right-sided mastoid emissary vein, tortuous scalp and paraspinal veins, and bilateral elongated styloid processes. CT angiography and digital subtraction angiography indicated Eagle syndrome-related compression of both internal jugular veins and concurrent occlusion of the left internal jugular vein at the jugular foramen. Consequently, given the risk of damaging venous structures, Gamma Knife radiosurgery was chosen over resection.
CONCLUSIONS: This case highlights the importance of adapting treatment plans based on patient-specific anatomical and pathological factors. In situations in which traditional surgery poses risks to sensitive structures such as the venous system, alternative approaches like radiosurgery offer safer yet effective options. Comprehensive risk-benefit evaluations are crucial for such decisions.
摘要：
背景：鹰综合征，一个不常见的情况，由于细长的茎突或钙化的茎突韧带引起的神经和/或血管压迫引起的症状，并且还可能使其他计划的外科手术复杂化。
方法：一名42岁女性失去平衡，头晕,共济失调步态接受了颅骨磁共振成像（MRI），显示右侧Koos四级前庭神经鞘瘤.最初，计划进行乙状窦后开颅手术切除肿瘤.然而,术前MRI和计算机断层扫描（CT）显示右侧乳突使者静脉扩张，曲折的头皮和椎旁静脉，和双侧细长的茎突。CT血管造影和数字减影血管造影显示，与Eagle综合征相关的颈内静脉受压，颈内孔左颈内静脉同时闭塞。因此,考虑到静脉结构受损的风险，选择伽玛刀放射外科而不是切除。
结论：该病例强调了根据患者的解剖和病理因素调整治疗计划的重要性。在传统手术对静脉系统等敏感结构构成风险的情况下，诸如放射外科等替代方法提供了更安全有效的选择。全面的风险效益评估对于此类决策至关重要。
方法：一名42岁女性失去平衡，头晕,共济失调步态接受了颅骨磁共振成像（MRI），显示右侧Koos四级前庭神经鞘瘤.最初，计划进行乙状窦后开颅手术切除肿瘤.然而,术前MRI和计算机断层扫描（CT）显示右侧乳突使者静脉扩张，曲折的头皮和椎旁静脉，和双侧细长的茎突。CT血管造影和数字减影血管造影显示，与Eagle综合征相关的颈内静脉受压，颈内孔左颈内静脉同时闭塞。因此,考虑到静脉结构受损的风险，选择伽玛刀放射外科而不是切除。
结论：该病例强调了根据患者的解剖和病理因素调整治疗计划的重要性。在传统手术对静脉系统等敏感结构构成风险的情况下，诸如放射外科等替代方法提供了更安全有效的选择。全面的风险效益评估对于此类决策至关重要。
