An intratemporal facial nerve neuroma: a case report

Yıl 2003, Cilt: 10 Sayı: 4, 159 - 162, 15.08.2003

İbrahim Ketenci Yaşar Ünlü Erkun Tuncer Abdulhakim Coşkun

Öz

A forty-one-year-old man presented with right-sided Progressive facial nerve paralysis of one year duration. Computed tomography of the temporal bone showed a soft tissue mass in relation with the tym- panic segment of the facial nerve with destructive changes in the facial recess region. Magnetic reso- nance images before and after gadolinium injection revealed a contrast-enhancing mass lesion in the tympanic cavity. The tumor was removed through a transmastoid approach and a cable graft from the greater auricular nerve was used to repair the defect.Histopathologic diagnosis was facial nerve schwannoma. At the end of one-year follow-up, the patient had moderately severe facial nerve dysfunction.

Anahtar Kelimeler

Facial nerve/radiography, facial nerve diseases/ diagnosis/surgery, facial paralysis/etiology/radiography, mag­netic resonance imaging, neurilemmoma/diagnosis, neuroma/ diagnosis/surgery/radiography, tomography, X-ray computed

Intratemporal fasyal sinir nöromu: Olgu sunumu

Öz

Kırk bir yaflındaki erkek hasta, sol tarafı tutan, bir yıl- dır yavafl geliflim gösteren fasyal paralizi flikayeti ile baflvurdu. Temporal kemik bilgisayarlı tomografisinde fasyal sinirin ikinci dirseği hizasında, orta kulağa doğ- ru uzanan ve fasyal reses bölgesinde tahrip edici de- ğifliklere yol açan yumuflak doku kitlesi görüldü. Ga- dolinum ile yapılan menyetik rezonans görüntüleme- de orta kulak boflluğunda kontrast madde tutan kitle saptandı. Transmastoid yolla girilerek, fasyal sinirdeki kitle cerrahi sınırlarda rezeke edildi ve n. aurikularis magnustan alınan sinir grefti ile tamir edildi. Histopa- tolojik incelemede fasyal sinir schwannomu tanısı kondu. Ameliyattan bir yıl sonra yapılan incelemede fasyal sinir fonksiyonunda kısmi düzelme görüldü

Anahtar Kelimeler

Fasyal sinir/radyografi, fasyal sinirhastalıkları/tanı/cerrahi, fasyal paralizi/etyoloji/radyografi, manyetik rezonans görüntüleme, nörilemoma/tanı, nöroma/tanı/cerrahi/radyografi, bilgisayarlı tomografi

Kaynakça

• Kayem MJ, Dufour JJ, Robert F. Development of a schwannoma within a facial nerve neurofibroma: a case report and literature review. Otolaryngol Head Neck Surg 1995;112:483-7.
• Prasad S, Myers EN, Kamerer DB, Demetris AJ. Neurilemmoma (schwannoma) of the facial nerve pre- senting as a parotid mass. Otolaryngol Head Neck Surg 1993;108:76-9.
• Sanna M, Zini C, Gamoletti R, Pasanisi E. Primary intratemporal tumours of the facial nerve: diagnosis and treatment. J Laryngol Otol 1990;104:765-71.
• Gulya AJ, Stern NM. Facial nerve neuroma. Ann Otol Rhinol Laryngol 1993;102:478-80.
• Martin N, Sterkers O, Mompoint D, Nahum H. Facial nerve neuromas: MR imaging. Report of four cases. Neuroradiology 1992;34:62-7.
• Saleh E, Achilli V, Naguib M, Taibah AK, Russo A, Sanna M, et al. Facial nerve neuromas: diagnosis and management. Am J Otol 1995;16:521-6.
• Shankar L, Hawke M, Leekam RN, Rutka J. Computed tomographic analysis of the intratemporal facial nerve and facial nerve neuromas. Can Assoc Radiol J 1989; 40:150-5.
• Vrabec JT, Guinto F Jr, Nauta HJ. Recurrent facial neu- romas. Am J Otol 1998;19:99-103.
• Schaitkin B, May M. Disorders of the facial nerve. In: Kerr AG, Booth JB, editors. Scott-Brown’s otolaryngology. Vo l . 3, 6th ed. Oxford: Butterworth-Heinemann; 1997. p. 1-38.
• Lipkin AF, Coker NJ, Jenkins HA, Alford BR. Intracranial and intratemporal facial neuroma. Otolaryngol Head Neck Surg 1987;96:71-9.
• Marsh MA, Coker NJ, Jenkins HA. Temporal bone neo- plasms and lateral cranial base surg e r y. In: Cummings C W, Fredrickson JM, Harker LA, Krause CJ, Schuller DE, editors. Otolaryngology head & neck surg e r y. Vol. 4, 3rd ed. St. Louis: Mosby-Year Book; 1998. p. 3245-81.
• O’Donoghue GM, Brackmann DE, House JW, Jackler RK. N e u romas of the facial nerve. Am J Otol 1989;10:49-54.
• Daniels DL, Czervionke LF, Millen SJ, Haberkamp TJ, Meyer GA, Hendrix LE, et al. MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery. Radiology 1989;171:807-9.
• Inanlı S, Tutkun A, Ozdemir R, Korkmaz M, Batman C, Sehitoglu MA. A case of facial nerve schwannoma. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 1999;6:94-6.
• Fagan PA, Misra SN, Doust B. Facial neuroma of the cerebellopontine angle and the internal auditory canal. Laryngoscope 1993;103(4 Pt 1):442-6.
• Van Den Abbeele T, Viala P, Francois M, Narcy P. Facial neuromas in children: delayed or immediate surgery? Am J Otol 1999;20:253-6.
• Pulec JL. Management of intratemporal tumours. In: Fisch U, editor. Facial nerve surgery. Birmingham: AL Kugler Amstelveen/Aesculapis; 1977. p. 423-69.
• Zini C, Sanna M, Jemmi G, Gandolfi A. Transmastoid extralabyrinthine approach in traumatic facial palsy. Am J Otol 1985;6:216-21.
• Symon L, Cheesman AD, Kawauchi M, Bordi L. Neuromas of the facial nerve: a report of 12 cases. Br J Neurosurg 1993;7:13-22.