| Popis: |
Background: Vestibular schwannoma (VS) or acoustic neuroma is a benign brain tumor. Despite improvements in surgical technique, the removal of VS is related to some complications of which the recovery is difficult and sometimes lead to permanent deficits. About 10.7% of complication of vestibular schwannoma surgery is reported to affect facial or tongue area, including numbness of pain, which is similar to a typical symptom of burning mouth syndrome (BMS). However, up to our knowledge, there is no documented case of BMS either comorbid with vestibular schwannoma or occur due to surgery complications. Clinical Presentation: A 46-year-old woman complained about left-sided facial pain, a burning sensation on the left side of her tongue and maxilla, and a spontaneous bitter taste. Four years before her first visit to our clinic, left-sided facial pain and burning sensation on the left side of the tongue suddenly became severe. She visited a neurosurgeon and VS was found in the left cerebellopontine angle. After the tumor was removed, facial pain, burning sensation of the tongue, and bitter taste improved simultaneously but quickly recurred after a while. The patient had a panic attack because of severe pain and started visiting a psychiatrist. The psychiatrist diagnosed her as having somatic symptom disorder and depression, prescribing sertraline 100 mg, zolpidem 5 mg, and lorazepam 1.0 mg and referred her to our clinic. At the first visit, no abnormal intraoral nor extraoral findings were detected. Based on the characteristics of the pain, we made a diagnose of BMS. Amitriptyline was initiated at 10 mg/day and increased to 30 m. Within 1.5 months, the pain and burning sensation of the tongue and maxilla almost remitted completely, whereas bitter taste showed moderate improvement. Conclusions: Our case suggests there might be an exceptional case in which BMS and VS can occur simultaneously. Specifically, an oral burning sensation and dysgeusia after VS surgery are not always a case of surgical complication or untreatable. |
