Öz

Schwannomlar periferik sinir schwann hücrelerinden kaynaklanan benign tümörlerdir. Baş ve boyun bölgesinde yaygın görülürler. Orta kulakta nadir görülmekle birlikte paragangliomalardan sonra ikinci en sık benign orta kulak tümörüdür. Orta kulakta en sık fasiyal sinirden ve korda timpani, stapedial sinir gibi dallarından kaynaklanır. Fasiyal sinir kaynaklı schwannomlar fasiyal sinir semptomlarından ziyade iletim tipi işitme kaybına neden olur. 3 ay önce gelişen periferik fasiyal paralizisi olan 59 yaşında erkek hastanın, yaklaşık 10 yıldır sol kulakta işitme kaybı yakınması mevcuttu. Yapılan radyolojik incelemelerde sol orta kulak boşluğunu tama yakın dolduran yumuşak doku dansitesinde, glomus tümörü, enflamatuar değişiklikler düşündüren patolojik görünüm mevcuttu. Hastaya timpanomastoidektomi yapıldı. Orta kulağı dolduran mavi morumsu renkte kitle izlendi. Kitlenin patolojik tanısı schwannom olarak rapor edildi. Bu sunuda nadir görülen bir orta kulak benign tümörü olan schwannom olgusu sunuldu

Anahtar Kelimeler

• Schwannom,fasiyal siniri; orta kulak

FACIAL NERVE SCHWANNOMA LOCATED IN THE MIDDLE EAR

Öz

Schwannomas are benign tumors originating from peripheral nerve, schwann cells, and located in head and neck region commonly. They are the second most common middle ear tumors after paragangliomas, and they may often arise from the facial nerve and also from its branches such as the chorda tympani and the stapedial nerve. Facial nerve schwannomas cause conductive hearing loss rather than usual symptoms of facial nerve. Our patient was 59-year -old man, who had hearing loss on his left ear for 10 years and who had facial paralysis for 3 months before coming to our clinic. Temporal bone computerized tomography scan showed soft tissue mass involving the timpanic cavity completely, which suggest glomus tumor or inflamatory changes. Tympanomastoidectomy operation was performed. The histopathological diagnosis of the mass was reported as schwannoma. In this case, we presented the schwannoma as a rare benign tumor of the middle ear.

Anahtar Kelimeler

• Schwannoma,facial nerve; middle ear.

Kaynakça

1. Amoils CP, Lanser MJ, Jackler RK. Acoustic neuroma presenting as a middle ear mass. Otolaryngol Head Neck Surg 1992; 107(3): 478–82.
2. Benecke JE, Noel FL, Carberry JN, House JW, Patterson M. Adenomatous tumors of the middle ear and mastoid. Am J Otol 1990;11(1): 20–26.
3. Botrill LS, Chamla OP, Ramsay AD. Salivary gland choristoma of the middle ear. J Laryngol Otol 1992; 106(7): 630–32.
4. Tralla M, Schindler RA. Twelfth nerve neurilemmona occurring in the middle ear. Otolaryngol Head Neck Surg 1982; 90(5): 662–64.
5. Kalai U. Conductive hearing loss secondary to a schwannoma involving the middle ear. Am J Otol 1994; 15(6): 817.
6. Zhang Q, Jessurun J, Schachern B, Paparella MM, Fulton S. Outgrowing schwannomas arising from tympanic segments of the facial nerve. Am J Otol 1996; 17(5): 311–15.
7. Ichimura S, Yoshida K, Sutiono AB,et al. Greater petrosal nerve schwannomas-analysis of four cases and review of the literature. Neurosurg Rev 2010; 33(4): 477–82.
8. Aydin K, Maya MM, Lo WW, Brackmann DE, Kesser B. Jacobson's nerve schwannoma presenting as middle ear mass. AJNR Am J Neuroradiol 2000; 21(7): 1331-33.

9. Kida Y, Yoshimoto M, Hasegawa T. Radiosurgery for facial schwannoma. J Neurosurg 2007; 106(1): 24–29.
10. Schuknecht HF. Pathology of the Ear. Philadelphia, Lea and Febiger, 1993; 472.
11. Wilkinson EP, Hoa M, William H, et al. Evolution in the Management of Facial Nerve Schwannoma. Laryngoscope 2011; 121(10): 2065–74.
12. Lee JD, Kim SH, Song MH, Lee HK, Lee WS. Management of facial nerve schwannoma in patients with favorable facial function. Laryngoscope 2007; 117(6): 1063–68.