上顎後間隙及顱底之三叉神經鞘瘤－病例報告

Trigeminal Schwannoma of Left Retromaxillary Space and Cranial Base-A Case Report

張雅菁(Ya-Ching Chang) ； 陳志偉(Chih-Wei Chen) ； 顔欽堉(Chin-Yu Yen) ； 張敏德(Min-Te Chang) ； 林建人(Ching-Cheng Tseng) ； 曾慶誠(Chien-Jen Lin) ； 廖國安(Kuo-An Liao)

《臺灣口腔顎面外科學會雜誌》 21卷4期 (2010/12) Pp. 310-320

https://doi.org/10.7104/TJOMS.201012.0310

摘要

顱外三叉神經鞘瘤是相當罕見的腫瘤。本文提出一位六十歲女性在其左臉頰內有一生長緩慢、與症狀的巨大腫瘤。核磁共振造影檢查顯示在其左側上顎後間隙有一50×30×53毫米之腫瘤，並侵犯左側翼㬽窩、眶上裂、圓孔、翼管及左蝶竇，懷疑是源起於三叉神經第二分支的神經源性腫瘤。該患者於全身麻醉下接受合併左額骨顯骨切開術及勒福一式截骨術將腫瘤切除。組織病理學檢查確立診斷爲神經鞘瘤。息者目前定期於本院門診追蹤。本文回顧文獻論神經鞘瘤之相關特性及切除位於此區腫瘤的手術方式。

關鍵字

神經鞘瘤 ； 三叉神經 ； 勒福一型截骨術

並列摘要

Trigeminal schwannomas with exclusive extracranial involvement are rare neoplasms. We report a case of a 60-year-old woman who had a slowly growing, large mass on the left cheek. Magnetic resonance imaging examination revealed one 50×33×53 mm mass lesion at left retromaxillary space with involvement of left pterygopalatine fossa, superior orbital fissure, foramen rotundum, vidian canal and left sphenoid sinus; neurogenic tumor from CNV2 was suspected. The tumor was treated by a combined frontotemporal approach and transmaxillary approach (LeFort I osteostomy) under general anesthesia. Diagnosis has been confirmed as schwannoma by post-operative histopathological examination. The patient is scheduled for regular follow-up in our department. This article reports a case of schwannoma and review the literature about the nature and surgical approach of the tumor in this area.

並列關鍵字

Schwannoma ； trigeminal nerve ； LeFort I osteotomy