听神经瘤并发同侧三叉神经痛、面瘫及对侧面肌痉挛1例临床分析

Acoustic neuroma complicated by ipsilateral trigeminal neuralgia,facial paralysis and contralateral muscle spasm(analysis of 1 case)

目的加深听神经瘤合并三叉神经痛及面肌痉挛的认识,思考桥小脑区肿瘤和颅神经功能障碍的发病机制。方法回顾性分析就诊我科的1例听神经瘤并发同侧三叉神经痛、面瘫及对侧面肌痉挛的临床影像学资料,同时复习相关文献。结果该患者因"左侧眼眶部疼痛不适6月余"收住入院,头颅MRI及CT检查提示桥小脑区占位,考虑听神经瘤并接受手术治疗,术后病理提示听神经鞘瘤,术后随访4个月,肿瘤无残留,同侧三叉神经痛及对侧面肌痉挛较术前缓解,同侧面瘫同术前。结论听神经瘤是桥小脑区常见的起源于听神经鞘的良性肿瘤,临床上听神经鞘瘤并发同侧三叉神经痛及对侧面肌痉挛的文献报道较少,本文通过报道1例听神经瘤合并同侧三叉神经痛及对侧面肌痉挛患者,切除肿瘤后,同侧三叉神经痛及对侧面肌痉挛明显改善,为听神经瘤合并相关颅神经功能障碍的机制提供一定的参考。

Objective To deepen acoustic neuroma with trigeminal neuralgia and facial spasm,thinking cerebellopontine area tumors and the pathogenesis of cranial nerve dysfunction.Methods To analyze the clinical imaging data of a case of acoustic neuroma with ipsilateral trigeminal neuralgia and contralateral muscle spasm confirmed by surgery and pathology in our department,and review the relevant literature.Results The patient was admitted to the hospital due to“left orbital pain and discomfort for more than 6 months”.The pain was mainly in the infraorbital-maxillary area,accompanied by shallow nasolabial folds on the left side of the face,and the corner of the mouth was tilted to the right.CT examination showed that the cerebellopontine area was occupied.Consider acoustic neuroma and undergo surgical treatment.Postoperative pathology suggested acoustic schwannoma.The tumor was followed up for 4 months after the operation.There was no recurrence of the tumor.Ipsilateral trigeminal neuralgia and contralateral muscle spasm were relieved compared with preoperatively.Conclusion Acoustic neuroma is a common benign tumor in the cerebellopontine area that originates from the auditory nerve sheath.Clinically,there are few reports of acoustic neuroma with ipsilateral trigeminal neuralgia and contralateral muscle spasm.After remove tumor,this case of acoustic neuroma with ipsilateral Trigeminal neuralgia and contralateral muscle spasm was relieved,which provided a certain reference for the pathogenesis and treatment of the disease.