论文部分内容阅读
目的:总结分析面神经鞘膜瘤误诊的原因,以期提高临床医生对面神经鞘膜瘤的认识。方法:回顾性分析16例面神经鞘膜瘤患者,收集这些患者的初发症状、诊疗经过、影像学结果、手术情况、预后等资料。结果:16例患者中10例曾被误诊,6例在外院误诊为突发性面瘫,2例在外院误诊为中耳胆脂瘤,2例在术前诊断为听神经瘤。前8例在完善MRI检查后得以确诊,后2例仅依靠术中所见而确诊。结论:对于面瘫患者建议及时完善MRI检查排除面神经瘤的可能,尤其是复发性或进行性面瘫、长期耳漏及面瘫患者。对于孤立的内听道、桥小脑角占位,即使患者仅存在听觉症状而无面神经症状,仍需考虑非典型面神经瘤的可能并了解患者对治疗方案的选择情况。
OBJECTIVE: To summarize and analyze the causes of misdiagnosis of facial nerve sheath tumor in order to improve clinicians’ understanding of facial nerve sheath tumor. Methods: A retrospective analysis of 16 patients with facial nerve sheath tumor, collecting the initial symptoms of these patients, diagnosis and treatment, imaging results, surgery, prognosis and other data. Results: Of the 16 patients, 10 were misdiagnosed, 6 were misdiagnosed as sudden facial paralysis in the Outer Hospital, 2 were misdiagnosed as middle ear cholesteatoma in the Outer Hospital, and 2 were diagnosed as acoustic neuroma preoperatively. The first 8 cases were diagnosed after perfecting MRI examination, the latter 2 cases were confirmed only by intraoperative findings. Conclusion: For patients with facial paralysis, it is suggested to improve MRI examination in time to exclude the possibility of facial neuroma, especially recurrent or progressive facial paralysis, long-term ear leaks and facial paralysis patients. For isolated internal auditory canal, bridging the cerebellopontine angle occupies the possibility of atypical facial neuromas and understanding the patient’s choice of treatment options, even if the patient has only auditory symptoms without facial nerve symptoms.