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目的:探讨以三叉神经痛或面肌痉挛为首发症状的桥小脑角区肿瘤的临床特点。方法:将国家卫健委中日友好医院神经外科自2015年5月至2018年11月收治的以三叉神经痛或面肌痉挛为首发症状、术前影像学检查或术中发现为桥小脑角区肿瘤的70例患者纳入病例组，将同期收治的无三叉神经痛或面肌痉挛表现的66例桥小脑角区肿瘤患者纳入对照组，对比分析2组患者间性别、年龄、病程、肿瘤性质、肿瘤大小等临床资料的差异。结果:病例组中首发症状为三叉神经痛者54例，首发症状为面肌痉挛者16例。病例组中男女比例约1∶2.18，与对照组(1∶3.00)相比差异无统计学意义(n P>0.05)。病例组的中位病程[36(24，84)个月]明显长于对照组[6(2，24)个月]，差异有统计学意义(n P<0.05)。病例组中胆脂瘤34例(48.6%)、脑膜瘤24例(34.3%)、听神经瘤8例(11.4%)、脂肪瘤2例(2.9%)、颈静脉球瘤2例(2.9%)，对照组中听神经瘤39例(59.1%)、脑膜瘤18例(27.3%)、胆脂瘤5例(7.6%)、颈静脉球瘤3例(4.5%)、脂肪瘤1例(1.5%)。病例组的肿瘤大小[2.00(1.60，4.25) cmn 2]明显小于对照组[5.60(4.00，8.50) cmn 2]，差异有统计学意义(n P0.05). The median course of disease in the experimental group was 36 (24, 84) months, which was significantly longer than that in the control group (9 [2, 24] months,n P<0.05). In the experimental group, 34 patients (48.6%) had cholesteatoma, 24(34.3%) had meningioma, 8 (11.4%) had acoustic neuroma, 2 (2.9%) had lipoma, and 2 (2.9%) had jugular bulb tumor. In the control group, 39 patients (59.1%) had acoustic neuroma, 18 (27.3%) had meningioma, 5 (7.6%) had cholesteatoma, 3 (4.5%) had jugular bulb tumor, and one (1.5%) had lipoma. The tumor size in the experimental group (2.00 [1.60, 4.25] cmn 2) was significantly smaller than that in the control group (5.60 [4.00, 8.50] cmn 2, n P<0.05). In the experimental group, 53 patients (75.7%) were found to have offending arteries compressing on corresponding cranial nerves during surgery; the offending artery of patients with TN was superior cerebellar artery; that of 14 patients with HFS was anterior inferior cerebellar artery and that of 2 patients with HFS was posterior inferior cerebellar artery. All patients with confirmed offending arteries underwent microvacular decompression (MVD) after tumor resection. The patients in the experimental group were followed up for 2-48 months after surgery, and the TN or HFS symptoms disappeared.n Conclusions:The female patients with CPA tumors with TN or HFS as first symptoms are more common, and TN is far more common than HFS. Cholesteatoma is the most common tumor. As compared with patients with CPA tumors without TN or HFS, CPA tumors patients with TN or HFS have longer course of disease and smaller tumor volume. Most patients have offending vascular compression on the corresponding cranial nerves, tumor resection+MVD is safe and effective treatment for these patients.