中华耳科学杂志Issue(3)：396-401,6.DOI:10.3969/j.issn.1672-2922.2014.03.011
面神经肿瘤的诊断及治疗进展
Facial Nerve Neuromas:Diagnosis and management
摘要
Abstract
Objective To discuss on clinical features, radiological characteristics, differential diagnosis and surgical approaches in treating facial nerve tumors and repairing the nerve, as well as treatment outcomes. Methods Cases of facial nerve tumor cases reported after 2002 in Pubmed, Medline, LWW, Elsevier, Springer, CKNI and CQVIP were reviewed in comparison to cases treated by the authors. Results A total of 23 reports were identified covering a total of 354 cases. The average onset age 43.90 years and sex ratio was 1:1.1. Facial palsy, hearing loss and tinnitus were the most common present-ing symptoms. In 271 of the 354 cases, facial nerve function before operation were reported (normal=113, House-Brackman grade II=30, H-B grade III=38, H-B grade IV=29, H-B grade V=29, H-B grade VI=32. The horizontal segment and geniculate ganglion were the most location of involvement. Surgical approach selection depended on tumor location and hear-ing level before operation. Mastoid and labyrinthine approach were commonly used. Facial nerve repairing method was dictat-ed by the length of facial nerve defect and the availability of facial nerve stump . Greater auricular nerve grafts were the most common material used to repair facial nerve in our cases. Of the 208 cases with followed-up data, facial function reached H-B grade I in 34 cases, H-B grade II in 27 cases, H-B grade III in 76 cases, H-B grade IV in 48 case s, H-B grade V in 6 cases and H-B grade VI in 17 cases. Conclusion Facial palsy, hearing loss and tinnitus are the most common symptoms in facial nerve tumors. The seemingly impossible facial nerve tumors must be considered in patients with facial palsy. The hori-zontal segment and geniculate ganglion are most often involved in facial nerve tumors. Selection of operation approach is de-termined by the location and site of the tumor and if residual hearing is to be preserved. Facial nerve repair should be consid-ered unless examination indicates complete loss of facial function and electromyography shows no action potentials before op-eration. Better facial nerve function before operation often suggest better prognosis of facial function recovery.关键词
面神经肿瘤/手术治疗/面神经修复/面神经功能Key words
Facial nerve neuroma/Operation therapy/Facial nerve repair/Facial nerve function分类
医药卫生引用本文复制引用
王萌萌,韩维举,王若雅,吴军..面神经肿瘤的诊断及治疗进展[J].中华耳科学杂志,2014,(3):396-401,6.基金项目
国家自然科学基金面上项目 （）
