顔面痙攣，顔面神経麻痺を呈した側頭骨錐体部の血管腫の1例

A Case Report of Hemangioma of the Petrous Bone which Caused Facial Spasm and Facial Palsy

I．はじめに

　頭蓋骨の血管腫は，全頭蓋骨良性腫瘍の約10％を占めるが，その多くは頭蓋穹窿部に発生し，頭蓋底部には稀である．

　箸者らは，側頭骨錐体部に発生した血管腫により，顔面筋の痙攣，および顔面神経麻痺を呈した1例を経験した．稀な疾患であるとともに，顔面痙攣を呈したことが興味深いと思われたので，文献的考察を加えて報告する．

Abstract

A rare case of hemangioma of the petrous bone is described. A 31-year-old woman suffered from right fa-cial twitching and palsy. So she underwent a craniec-tomy intending microvascular decompression of the fa-cial nerve, but no compressing vessels or tumors were found. Three years later, however, her facial fascicula-tion disappeared spontaneously, but facial weakness de-teriorated and she began to feel vertigo.

On admission, neurological examination revealed right facial palsy of the peripheral type, slight hearing disturbance, and canal palsy. Bone-window CT and T2-weighted MRI revealed a small tumor destroying the petrous bone near the geniculate portion of the facial nerve.

Using the epidural subtemporal approach, the tumor was totally removed and the facial nerve remained in-tact. Histologic-ally it was diagnosed as hemangioma. Hemangioma of the skull base bone is rare, and it is interesting that the tumor in this case caused abnormal facial contraction like hemifacial spasm.