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目的 :探讨面神经瘤误诊的缘由。方法 :统计 1 980至 1 996年中华耳鼻咽喉科杂志、临床耳鼻咽喉科杂志及作者经治的面神经瘤 44例 ,其中误诊 2 5例。对主要临床症状 ,手术发现病变的部位 ,手术前误诊 ,误诊病例手术发现病变的部位进行比较分析。结果 :对长期渐进性面神经功能不良 ,听力减退 ,外耳道、颌下、腮腺区肿块等症状应作系统耳神经学检查及颞骨、颅脑、桥小脑角X线摄片及CT摄片 ,以期早期诊断面神经瘤。面神经瘤的病理学行为和不同部位的发生率尚不完全清楚 ,面神经瘤可发生在颞骨内抑或颞骨外 ,所以临床症状多种多样 ,加之目前对此瘤术前诊断能力有限 ,临床上常误诊为Bell面瘫、慢性化脓性中耳炎、颈静脉球体病、桥小脑角病变、腮腺肿瘤等。结论 :面神经瘤可原发面神经任何节段 ,临床亦表现为不同部位先后发病 ,且可迁延发展致多部位罹病 ,经再次手术发现面神经瘤病变 ,本组 2 5例误诊病例就表现为颞骨内、外先后发病和 (或 )同时发病。因此 ,需对颞骨内面神经瘤病理行为学进行深入研究。
Objective: To investigate the reason of misdiagnosis of facial neuroma. Methods: Forty-four cases of facial neuroma treated by the Journal of Otolaryngology and Otorhinolaryngology from January to September of 1996 were enrolled in this study, of which 25 were misdiagnosed. The main clinical symptoms, surgical findings of the site of the lesion, misdiagnosis before surgery, misdiagnosed cases of surgical lesions were compared. Results: Long-term progressive facial nerve dysfunction, hearing loss, external auditory canal, submandibular, parotid gland mass and other symptoms should be made for systematic otological examination and temporal bone, cranial brain, cerebellopontine angle X-ray and CT radiography, with a view to early Diagnosis of facial neuroma. The pathological behavior of facial neuroma and the incidence of different parts is not yet fully understood, facial neuroma can occur in the temporal bone or the temporal bone, so a variety of clinical symptoms, combined with the limited ability of this tumor preoperative diagnosis, clinically misdiagnosis Bell facial paralysis, chronic suppurative otitis media, jugular bulb spondylosis, cerebellar angle lesion, parotid gland tumors. CONCLUSIONS: Facial neuroma may have any segment of the primary facial nerve. It also manifests itself in different parts of the body. It may delay the development of multiple parts of the disease. After resection, the facial neuroma is found. Twenty-five cases of misdiagnosis have been found in the temporal bone , Outside the disease and (or) the same time the disease. Therefore, the need for deep temporal bone neuropathology and behavioral studies.