脳神経減圧術後に見られた前庭神経，顔面神経損傷の1例

Selective Injury of the Vestibular and Facial Nerves Following Microvascular Decompression Procedures for Hemifacial Spasm: A case report

I．はじめに

　小脳橋角部手術の合併症としての聴力障害についてはこれまでに多くの論及がなされている^7,9）．しかし前庭神経の損傷については殆ど論じられていない．今回，われわれは脳神経減圧術後に聴力は良好に温存されたが，前庭神経と顔面神経が選択的に損傷された症例を経験し詳細な神経耳科的検討を行った，本症例は小脳橋角部手術による合併症としての前庭神経，顔面神経損傷の発生機序を考察する上で貴重な症例と考えられたので報告する．

Microvascular decompression procedures were car-ried out to relieve right hemifacial spasm in a 54-year-old man. His facial spasm was satisfactorily cured but he complained of severe vertigo, and slight facial palsy was also shown after the operation. Electronystagmo-graph disclosed spontaneous horizontal and rotatory nystagmus toward the non-operated (left) side. The postoperative caloric test showed profound dysf unction on the operated side. His hearing was well maintained postoperatively.