顳下窩之神經鞘瘤

Infratemporal Fossa Schwannoma

張大慶(Ta-Ching Chang) ； 蔡行生(Shin-Sheng Tsai) ； 談嘉俊(Chia-Jun Tang)

《台灣耳鼻喉頭頸外科雜誌》 38卷2期 (2003/04) Pp. 90-94

https://doi.org/10.6286/2003.38.2.90

摘要

神經鞘瘤(schwannomas)屬於良性周圍神經鞘腫瘤，源發於顳下窩的病例非常罕見，查閱英文文獻僅10例。常見的臨床表現為頰部腫脹、顏面疼痛、眼球脫出(proptosis)、扁桃線窩腫脹等。本科曾經歷1名23歲女性，主訴右臉頰無痛性緩慢腫脹已1年，理學檢查發現右上頜臼齒外側，有質地堅硬且表面光滑的腫瘤。電腦斷層及核磁共振攝影檢查顯示，有一界線分明的軟組織腫瘤，位於上頜竇後骨壁後方，推測為神經性腫瘤。經口腔實施病理組織切片，證實為神經鞘瘤。採用經口腔切除術取出腫瘤，術後追蹤2年，並無復發及神經學異狀。經口腔切除局限於顳下窩的良性腫瘤，可為顳下窩手術的另一選擇。

關鍵字

顳下窩 ； 神經鞘瘤

並列摘要

Schwannomas are benign peripheral nerve sheath tumors and rarely arise in the infratemporal fossa. There are only 10 cases reported in the English literature. The most common clinical manifestations are cheek swelling, facial pain, proptosis and tonsillar fossa swelling. We encountered a 23-year-old female who presented with progressive painless right cheek swelling for one year. Physical examinations revealed a smooth firm mass lateral to the right maxillary molars. CT and MRI revealed a solitary, well-circumscribed soft tissue tumor located behind the posterior wall of the right maxillary sinus. Provisional diagnosis based on the images study suspect a neurogenic tumor. Schwannoma was comfirmed by transoral biopsy. The patient underwent tumor excision via transoral approach. No evidence of recurrence or neurologic deficits is noted after 2 years. Transoral approach provides an alternative way to remove benign tumor limited in the infratemporal fossa.

並列關鍵字

infratempora fossa ； schwannoma