小脳橋角部三叉神経鞘腫一症例の神経耳科学的検討

A TRIGENINAL NEURINOMA OF THE CEREBELLOPONTINE ANGLE

　Ⅰ．緒言

　近年，眼平衡系を中心とした神経耳科学の進歩は著しいものがあり，われわれ耳鼻科医が脳神経科医に先立つて小脳橋角部腫瘍など診断を下し得る機会も少なくない。著者らは，長期間にわたつて三叉神経症状のみが持続し，術後性頬部嚢腫と診断されて上顎洞の再手術を受けたが，術後まもなくメマイを訴えるようになり，小脳橋角部病変が疑われる症状を呈するに至つた一症例を経験した。結局，三叉神経原発の神経鞘腫と判明したが本疾患が非常にまれであるだけでなく，神経耳科学的検討はほとんどなされておらず，また発病初期には鼻性三叉神経症候との鑑別が困難であつたという点で興味ある症例と考えられるので報告する。

　A case of trigeminal neurinoma of the cerebello-pontine angle is reported. The patient a man, aged 44, complained of hypesthesia of the left side of the face of few years standing.

　Previously elsewhere, a diagnosis of postoperative cyst of the left maxillary sinus was made followed by operation. No improvement was seen. About a month after this operation the patient became affected with the disturbance of the gait, vertigo and the loss of hearing. The diagnosis, now, was said to be peripheral vestibular disorder obtained from audiometry and vestibular function tests. Appropriate treatments were given but no improvement was seen in the patient's symptoms.

　The patient was seen at the authors' clinic. Following hospitalization the patient was given ncurootological examinations. As results of these examinations, it was concluded that the disturbances are caused by a pathological focus at the cerebello-pontine angle.

　The craniotomy was performed at the Neurological Department of the Kyushu University Hospital. A trigeminal neurinoma was found at the cerebello-pontine angle which was successfully removed. The patient made a marked recovery after this operation.