喉神经鞘瘤的诊断与治疗

Diagnosis and management laryngeal schwannoma

目的探讨喉神经鞘瘤的诊断与治疗。方法回顾性分析该科6a来诊治的5例喉神经鞘瘤。结果经随访2a以上,无1例复发,全部恢复喉功能,但不同程度地有发声疲劳和间断声嘶,1例术腔出现肉芽生长,经激光治疗后痊愈,无喉狭窄出现。结论喉神经鞘瘤为少见的喉部良性神经源性肿瘤,手术是最有效的治疗方法,喉裂开术是一简单且又能提供良好暴露的手术径路。

[Objective] To explore the diagnosis and management of the laryngeal Schwannoma. [Method] Five cases with laryngeal Schwannoma from January 1997 to December 2002 are analyzed retrospectively. In addition the literatures about this disease are reviewed. [Result] 5 cases had been followed up for 2 years to 7 years and no recurrence occurred. All patients have persisted vocal fatigue and intermittent dysphonia. One patient developed a granuloma along the false vocal fold where the mucosa had been excised. This was removed via an fibrolaryngoscope approach with the Nd： YAG laser. [Conclusion] Laryngeal Schwannoma is a rare benign neurogenie tumor, the diagnosis depend on CT and hisopatologic evaluation. Immunohistochemical analysis with S-100 （which is specific to schwann cells） is beneficial to differential diagnosis for neurofibromas. Laryngofissure is an effective approach for excision the mass.