鼓膜囊炎并发面神经麻痹1例。

Christodoulos Dimakis, Despoina Beka, Eustratios Papageorgiou, Nikolaos Tsetsos, Alexandros Poutoglidis, Athanasia Gortsali, Alexandros Nomikos, Georgios Karatzias
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摘要

简介:一般认为,血管球瘤是由颅底和颈部副交感神经副神经节的嗜铬细胞引起的自主神经系统肿瘤。中耳球囊瘤是中耳腔最常见的原发肿瘤,起源于中耳副神经节。病例报告:我们报告一位70岁女性的鼓室血管瘤,合并面神经麻痹,第一眼误诊为胆脂瘤。患者因耳漏、搏动性耳鸣及右耳听力下降而就诊。第一次检查(术前40天)面神经功能良好。最终,她成功地进行了乳突管壁下切除术。由于肿块大小及累及外耳道,在与患者讨论后选择了手术方法。结论:虽然在组织学上是良性的,但鼓室球生长缓慢,并可能破坏邻近组织。两种最常见的抱怨是听力损失(传导性)和脉动性耳鸣。这些肿瘤在女性中更常见,可以通过CT或MRI扫描诊断。当患者的临床表现为听力损失和搏动性耳鸣时,医生怀疑是血管球瘤是非常重要的,并使用血管内显像以支持鉴别诊断。
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A Case Report of Glomus Tympanicum Complicated With Facial Nerve Palsy.

Introduction: Generally, glomus tumors are considered tumors of the autonomic system arising from chromaffin cells of the parasympathetic paraganglia of the skull base and neck. Glomus tympanicum is the most common primary tumor of the middle ear cavity and it arises from the paraganglia of the middle ear.

Case report: We present a case of glomus tympanicum presented in a 70-year-old woman, complicated with facial nerve palsy which at first sight was misdiagnosed as cholesteatoma. Patient presented in our clinic because of otorrhea, pulsatile tinnitus and hearing loss in the right ear. However, facial nerve function was good in the first examination (40 days before the surgery). Eventually, she treated successfully with a canal wall down mastoidectomy. Technique had been chosen because of the mass size and the involvement of external auditory canal, after a discussion with the patient.

Conclusions: Although histologically benign, glomus tympanicum is slow growing and destructs adjacent tissues potentially. The two most common complaints are hearing loss (conductive) and pulsatile tinnitus. These neoplasms are more common in women and they can be diagnosed by CT or MRI scan. It is of high importance physicians suspect a glomus tumor when patient 's clinical findings are hearing loss and pulsatile tinnitus and use an intravascular agent in imaging so that the differential diagnosis will be supported.

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来源期刊
Iranian Journal of Otorhinolaryngology
Iranian Journal of Otorhinolaryngology Medicine-Otorhinolaryngology
CiteScore
1.30
自引率
0.00%
发文量
72
审稿时长
12 weeks
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