头颈部神经鞘瘤临床分析

Neurilemmoma in head and neck region

目的探讨头颈部神经鞘瘤的临床特征、诊断及治疗。方法回顾分析1977～2006年收治的23例头颈部及颅底神经鞘瘤患者的临床资料。结果头颈部神经鞘瘤主要表现为鼻塞、面瘫和声嘶等症状。20例患者术前行CT或MRI检查,诊断符合率分别为10%和20%。全部患者均行手术切除肿瘤,18例患者术中冰冻切片病理明确诊断。19例完整切除肿瘤,4例切除大部分肿瘤。共有19例术后随访,随访期3个月～10年,15例完整切除者无1例复发,4例部分切除者1例复发。术后并发持续性动眼神经麻痹3例,听力下降1例,声嘶1例。结论头颈部及颅底神经鞘瘤不易早期诊断,确诊有赖于病理检查,手术完整摘除是有效的治疗方法,预后良好。

OBJECTIVE To study the clinical features, diagnosis and treatment of neurilemmoma in head and neck region. METHODS The clinical data of 23 patients with neurilemmoma in head and neck and extracranial regions from 1977 to 2006 in our hospital were studied retrospectively. RESULTS The clinical symptoms of neurilemmoma were nasal obstruction, hoarseness and facial palsy, depending on the locations of the lesions invaded. Eighteen cases were diagnosed by the frozen section pathology during the operation. All patients were treated with surgical resection via relevant approaches. Nineteen cases were followed up from 3 months to 10 years. Among them, 15 cases with tumors totally removed had no recurrence, one of 4 cases with tumors partially removed recurred and received further radiotherapy and surgical treatment. Postoperatively, persistent oculomotor palsy was occurred in 3 cases, hearing loss in 1 case, persistent hoarseness in 1 case. CONCLUSION The diagnosis of neurilemmoma is established by pathological examination and complete surgical resection with appropriate approaches has proven to be efficient in the treatment of neurilemmoma in head and neck region.