误诊为原发典型三叉神经痛的桥小脑角胆脂瘤的临床研究

目的：探讨三叉神经痛型桥小脑角胆脂瘤的发生机制、临床表现和治疗原则。方法：回顾性总结21例以原发典型三叉神经痛为主要表现的胆脂瘤患者的临床表现、肿瘤生长部位与大小、手术入路与技巧、结果和术后并发症等资料。结果：肿瘤全切16例,次全切5例。所有患者均表现为同侧三叉神经痛。术中发现10例肿瘤将三叉神经包绕在瘤内。术后三叉神经痛均消失,面部感觉减退2例,听力减退1例;1例疑似无菌性脑膜炎。结论：桥小脑角区胆脂瘤与三叉神经痛的关系复杂,应采取手术治疗,术中根据肿瘤和周围结构的关系以确定是否全切,术后注意无菌性脑膜炎等并发症。

Clinical research of misdiagnosed primary typical trigeminal neuralgia of cerebellopontine cholesteatoma

Objective：To explore the mechanism,clinical manifestation and therapy for cholesteatoma of the cerebellopontine angle presented as trigeminal neuralgia.Methods：The clinical manifestation,location and size of the tumor,operative approaches and technique,results and complications of 21 patients with cholesteatoma presenting with trigeminal neuralgia as main manifestation were reviewed retrospectively.Results：Total removal was achieved in 16 cases,subtotal removal in 5 cases.All patients showed ipsilateral trigeminal neuralgia.In 10 cases during microsurgery,tumor was found surrounding the trigeminal nerve.All trigeminal neuralgia were cured,with facial hypoesthesia in 2 cases and hyporesthesia in 1 cases,one case suspected aseptic meningitis.Conclusion：The relationship between the cerebellopontine angle cholesteatoma and the trigeminal neuralgia was rather complex.the clinical manifestations of trigeminal neuralgia was not very typical.all patients should be taken to surgery.postoperative aseptic meningitis should be closely watched.