Primary tumors of the facial nerve misdiagnosed: a case series and review of the literature
Primary tumors of the facial nerve misdiagnosed: a case series and review of the literature
复制标题
面神经原发性肿瘤误诊：病例系列及文献复习
DOI：
10.1080/00016489.2016.1267405
复制
发表时间：
2017
影响因子：
1.4
通讯作者：
Shi
中科院分区：
文献类型：
--
作者：
H. Yi;Bin Hu;G. Yin;Xin Li;Jinkun Xu;Jingying Ye;Shi
摘要结论：进行性面瘫的患者应考虑到不常见的面神经原发性肿瘤，特别是伴有听力损失或眩晕的患者。误诊会增加手术难度，减少面神经重建的机会，增加重建效果不佳的可能性。目的：本文旨在确定多年前被误诊为无瘤状态的面神经原发性肿瘤的特征，并描述适当的治疗方法。研究方法：本文对11例误诊为原发性面神经肿瘤的病例进行了回顾性分析，所有病例均被误诊8年以上。所有患者均表现为进行性或完全性面瘫和听力损失，伴或不伴眩晕。对术前和术后影像（包括颞骨的CT扫描）和MRI数据进行了审查。结果如下：所有肿瘤均采用经乳突或经耻骨入路完全切除，证实为原发性面神经肿瘤。面神经舌下神经吻合术失败，因为纤维化的发展在年底的面神经在一个病人，本研究试图在两个阶段管理。1例患者接受面神经-舌下神经二期吻合术，患者状态由House-Brackmann（H-B）VI级改善为H-B V级。其他9名患者选择不接受重建。
Abstract Conclusion: Unusual primary tumors of the facial nerve should be considered in patients with progressive facial paralysis, especially if this is accompanied by hearing loss or vertigo. Misdiagnosis could increase the difficulties of operation, diminish the chance of facial nerve reconstruction, and increase the likelihood of poor reconstructive outcomes. Objective: This paper was to determine the characteristics of facial nerve primary tumors misdiagnosed as tumor-free conditions many years prior, and to describe appropriate treatments. Methods: The cases of 11 Chinese patients with misdiagnosed primary tumors of the facial nerve were reviewed; every one had been misdiagnosed for more than 8 years. All patients presented with progressive or complete facial paralysis and hearing loss, with or without vertigo. The pre- and post-operative images (including CT scans of the temporal bone) and MRI data were reviewed. Results: All tumors were completely resected using the translabyrinthine or transmastoid approach and were confirmed to be primary tumors of the facial nerve. Facial-hypoglossal nerve anastomosis failed because fibrosis developed at the end of the facial nerve in one patient whom this study sought to manage in two stages. One patient accepted facial-hypoglossal nerve anastomosis of two-stage and patient status improved to House-Brackmann (H-B) grade V from H-B grade VI. The other nine patients chose not to undergo reconstruction.