Clinical characteristics of cerebellopontine angle tumors with hemifacial spasm or trigeminal neuralgia as first symptoms
10.3760/cma.j.cn115354-20200814-00643
- VernacularTitle:以三叉神经痛或面肌痉挛为首发症状的桥小脑角区肿瘤的临床特点分析
- Author:
Xueke ZHEN
1
;
Hongxiang REN
;
Li ZHANG
;
Yanbing YU
Author Information
1. 国家卫健委中日友好医院神经外科，北京 100029
- Keywords:
Hemifacial spasm;
Trigeminal neuralgia;
Cerebellopontine angle tumor;
First symptom;
Microvascular decompression
- From:
Chinese Journal of Neuromedicine
2020;19(12):1204-1207
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of cerebellopontine angle (CPA) tumors with hemifacial spasm (HFS) or trigeminal neuralgia (TN) as first symptoms.Methods:From May 2015 to November 2018, 70 patients with CPA tumors found in preoperative imaging examination or during operation and with TN or HFS as first symptoms, were enrolled into experimental group; 66 patients with CPA tumors without TN or HFS were chosen as control group. Gender, age, course of the disease, pathological types of the tumors, and tumor sizes were retrospectively analyzed and compared between the two groups.Results:In the experimental group, 54 patients were with TN as first symptom and 16 were with HFS as first symptom. The ratio of male to female in the experimental group was about 1∶2.18, and the difference was not statistically significant as compared with that in the control group (1∶3.00, P>0.05). The median course of disease in the experimental group was 36 (24, 84) months, which was significantly longer than that in the control group (9 [2, 24] months, P<0.05). In the experimental group, 34 patients (48.6%) had cholesteatoma, 24(34.3%) had meningioma, 8 (11.4%) had acoustic neuroma, 2 (2.9%) had lipoma, and 2 (2.9%) had jugular bulb tumor. In the control group, 39 patients (59.1%) had acoustic neuroma, 18 (27.3%) had meningioma, 5 (7.6%) had cholesteatoma, 3 (4.5%) had jugular bulb tumor, and one (1.5%) had lipoma. The tumor size in the experimental group (2.00 [1.60, 4.25] cm 2) was significantly smaller than that in the control group (5.60 [4.00, 8.50] cm 2, P<0.05). In the experimental group, 53 patients (75.7%) were found to have offending arteries compressing on corresponding cranial nerves during surgery; the offending artery of patients with TN was superior cerebellar artery; that of 14 patients with HFS was anterior inferior cerebellar artery and that of 2 patients with HFS was posterior inferior cerebellar artery. All patients with confirmed offending arteries underwent microvacular decompression (MVD) after tumor resection. The patients in the experimental group were followed up for 2-48 months after surgery, and the TN or HFS symptoms disappeared. Conclusions:The female patients with CPA tumors with TN or HFS as first symptoms are more common, and TN is far more common than HFS. Cholesteatoma is the most common tumor. As compared with patients with CPA tumors without TN or HFS, CPA tumors patients with TN or HFS have longer course of disease and smaller tumor volume. Most patients have offending vascular compression on the corresponding cranial nerves, tumor resection+MVD is safe and effective treatment for these patients.
