以多颅神经麻痹为首发症状的头颈部肿瘤临床分析

Clinical analysis of head and neck tumors with multiple cranial nerve palsy as initial symptom

目的以多颅神经麻痹为首发症状的头颈部肿瘤临床诊断具有挑战性,本研究结合病例和文献深入探讨了疾病的病因诊断。方法回顾性研究2018年1月-2021年12月陕西省人民医院和空军军医大学唐都医院收治的4例以多颅神经麻痹为首发症状的头颈部肿瘤患者。结果1例颈静脉孔副神经节瘤第5、7、8、9对和第12对颅神经麻痹,1例颈静脉球瘤病变累及第7、8对颅神经,1例生殖细胞瘤波及第2、3、5、6、7、8对颅神经,1例鼻颅底腺癌第1、3、4、5、6、7、8对和第12对颅神经瘫痪。结论多颅神经麻痹可作为头颈部潜在良、恶性肿瘤早期唯一症状体征,病因诊断方面需警惕肿瘤新生物。

Objective The clinical diagnosis of head and neck tumors with multiple groups of cranial nerve palsy as the first symptom is challenging.Based on the cases,a review of literature was conducted to discussed the etiology of this rare disease.Methods A retrospective summary of 4 patients with multiple cranial nerve palsy as the first symptom admitted to Shaanxi Provincial People’s Hospital and Tangdu Hospital of Air Force Military Medical University from January 2018 to December 2021 were analyzed.Results A case of jugular foramen paraganglioma with the 5th,7th,8th,9th and 12th cranial nerve palsy,and one case of glomus jugular tumor involving the 7th and 8th cranial nerves.Case of germinoma affected the 2th,3th,5th,6th,7th and 8th cranial nerves,and nasal skull base adenocarcinoma had the 1th,3th,4th,5th,6th,7th,8th and 12th cranial nerves paralyzed.Conclusion Multiple cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck.In terms of etiological diagnosis,enough attentions should be paid to tumors.