顔面神経鞘腫が発見された成人急性乳突炎

A Case of Facial Nerve Schwannoma accompanied by Acute Mastoiditis

　はじめに

　側頭骨内顔面神経鞘腫は比較的まれであり，骨破壊を伴って進展してから発見される例が多く，部位が限局した小さな腫瘍の段階で発見された症例は少ない。今回われわれは，急性中耳炎から乳突炎の臨床像を呈し，急に顔面神経麻痺が出現した成人の症例を経験し，手術を施行したところ顔面神経水平部に限局した神経鞘腫を認め，神経束を保存して腫瘍を切除できたので，若干の文献的考察を加えて報告する。

A small facial nerve schwannoma was discovered during middle ear surgery in a 46-year-old female who underwent surgery for acute otitis media and mastoiditis associated with facial nerve palsy.

She had a past history of ipsilateral facial palsy, which recovered spontaneously in 3 weeks, 10 years ago. Mastoid air cells including retrofacial cells were well developed. Severe inflammation, caused by pneumococcal infection, was found in an exten-sive area from the mesotympanum to the mastoid cells. A neoplastic lesion was detected in the hori-zontal portion of the facial nerve. The tumor ac-companied with the nerve sheeth was extirpated under a microscope with preservation of the nerve bundle. Mastoidectomy with facial nerve decom-pression is recommended for patients with acute otitis media and mastoiditis associated with facial nerve palsy.