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目的:总结累及内耳道的面神经肿瘤的临床特点,探讨其鉴别诊断方法及治疗措施。方法:回顾总结复旦大学附属眼耳鼻喉科医院2013-01-2015-04期间手术治疗、病理证实的5例累及内耳道的面神经肿瘤患者的临床表现、诊断和治疗经验。结果:累及内耳道面神经肿瘤的主要症状以面瘫伴听力下降最常见。本组5例均为肿瘤全切,其中3例经迷路径路,1例经迷路耳囊径路,1例经颅中窝径路。2例进行了面神经重建,其中1例行面神经舌下神经吻合,1例行耳大神经移植。结论:累及内耳道的面神经肿瘤如出现面瘫H-B 4级以上可考虑手术,应根据患者的听力情况、面神经功能,肿瘤大小及侵犯范围选择相适应的干预策略。
OBJECTIVE: To summarize the clinical features of facial nerve tumors involving the inner ear canal and to explore the differential diagnosis methods and treatment measures. Methods: The clinical manifestations, diagnosis and treatment experience of 5 cases of facial nerve tumors involving internal auditory canal confirmed by surgery and pathology during the period of 2013-01-2015-04 were retrospectively reviewed. Results: The most common symptoms of facial nerve with facial paralysis and hearing loss were involved. The group of 5 cases were all tumor resection, of which 3 cases by the lost path, 1 case of lost ear path, 1 case by the middle cranial fossa path. Facial nerve reconstruction was performed in 2 cases. One case underwent sublingual nerve anastomosis of the facial nerve and one case underwent auricular nerve transplantation. CONCLUSIONS: Facial nerve tumors involving the inner ear canal may be considered for surgery in the presence of grade 4 or more of facial paralysis. Corresponding intervention strategies should be selected according to the patient’s hearing, facial nerve function, tumor size and range of invasion.