In order to find out the cause, Mr. Liu had an examination at a local hospital in Yulin, and the CT of his head showed that there was an intracranial mass lesion, and the doctor suspected that the facial pain was caused by the tumor. In order to further clarify the condition and **, he came to the outpatient clinic of Professor Jiang Haitao, an expert group of skull base cranial nerve diseases in the Department of Neurosurgery of the First Affiliated Hospital of Xi'an Jiaotong University.
Cranial nerve scintigraphy showed that uneven short T2 signals could be seen in the right prepontine cistern and pontine cerebellar angular cistern, which caused compression and distortion of the right trigeminal nerve, abducens nerve and facial nerve. The results of DW1 showed that the right pontine cerebellar angle area, prebridged cisterna and suprasellar cisterna were abnormal, and epidermoid cysts were considered. We can remove the tumor tissue in blocks during the operation through the right pontine cerebellar angle tumor resection, and relieve the compression of the three and you nerve, ** pain symptoms.
Epidermoid cysts originate from ectodermal tissue of ectopic embryonic remnant tissues and are the result of the introduction of the epidermis at the time of secondary brain cell formation in the late embryonic stage, and are a slow-growing congenital benign tumor. Because of its white color with pearl luster, it is also known as cholesteatoma or pearly tumor.
Epidermoid cysts (cholesteatoma) tend to occur in the infratentorial pontine cerebellar angle and supratentorial temporopole-lateral fissure, etc., and have strong damage to surrounding tissues, and patients often have trigeminal neuralgia and seizures, and the clinical manifestations are different according to the different growth sites. Surgical resection is the main method of this disease, and for patients with large lesions and obvious clinical symptoms, surgical complete resection should be sought as soon as possible.
What are the clinical manifestations of intracranial cholesteatoma?
1. Cerebellar pontine horn cholesteatoma.
It often begins with trigeminal neuralgia (70), and often has tinnitus on the affected side, deafness, decreased facial sensation, weak facial muscles, hearing loss, ataxia, etc.
2. Sellar cholesteatoma.
Visual loss and visual field defects are often the main clinical manifestations in the early stage, and a small number of patients may have endocrine disorders, manifested as hyposexuality, polydipsia, polyuria and other pituitary insufficiency and hypothalamic damage.
3. Intraparenchymal cholesteatoma.
Cerebral hemisphere tumors often have seizures, psychiatric symptoms and hemiplegia, and cerebellar tumors often have nystagmus and ataxia.
4. Ventricular cholesteatoma.
Obstruction of cerebrospinal fluid circulation causes symptoms of increased intracranial pressure.
5. Cranial cholesteatoma.
The skull is often found incidentally to be elevated for many years, with a rubbery sensation to the touch and no tenderness.
Cholesteatomas are often benign, but surgery should be done as soon as possible.
Cholesteatoma is mostly benign tumors, and the mass effect of the tumor can be detected by magnetic resonance, CT, and imaging examinations. At present, the main way is to be carried out through surgery, because it "can grow when you see the seams", and it often advocates early surgery, and the prognosis of postoperative patients is ideal. Because of the special location of growth, complex anatomy, and many adjacent blood vessels and nerves around it, cholesteatoma can basically be completely removed in the early stage, but in the later stage, it is very likely to erode the bone surrounding blood vessels and nerves, which makes the operation very difficult, and even requires a second operation if necessary.