顔面神経鞘腫の４症例

Abstract

Reports on facial nerve schwannoma have been gradually increasing, and it is no longer a rare disease. We have had 4 cases of facial nerve schwannoma in our clinic since October, 1978, when our clinic opened. The first case (a 34 year-old, female), a small schwannoma was found in the tympanic portion of the facial nerve when she underwent a tympanoplasty for cholesteatoma. The second case (a 45 year-old, female), suffered from slowly progressive facial nerve palsy and later from severe vertigo. The third case (a 73 year-old, male), experienced severe vertigo with long-term facial palsy, while the fourth case (a 60 year-old, male), suffered from sudden onset of slight facial palsy with a subauricular tumor. The patients with facial nerve schwannoma complained of various symptoms such as facial nerve palsy, hearing disturbance, vertigo or dizziness, tinnitus, otalgia or headache, depending on the site of occurrence and tumor size. A multitumor type of schwannoma originating from a single facial nerve such as case 4 is rare. We reviewed the literature covering 11 cases of the multitumor type of facial nerve schwannoma. When we encounter a facial palsy patient with fluctuating degrees of palsy, in addition to the variety of symptoms mentioned above, and who does not response to extensive treatment, a diagnosis of schwannoma is considered. Accordingly, the pathway of the facial nerve, from the CP-angle to the parotid gland is carefully examined. MRI is a suitable method for examination.