280例颈根部周围神经肿瘤临床治疗的回顾性分析

Retrospective analysis of clinical treatment for peripheral nerve tumors located in the root of neck in 280 cases

目的探讨颈根部周围神经肿瘤的临床手术入路及手术适应证的选择。方法回顾性总结分析湖南省肿瘤医院头颈外科1995年1月～2009年1月诊治的280例颈根部周围神经肿瘤的手术治疗及临床疗效。结果 280例颈根部周围神经肿瘤被顺利整体切除,术后随访3年。良性肿瘤221例,复发10例,其中1例椎管复发致死亡。恶性肿瘤59例,其中16例神经纤维肉瘤出现局部复发及远处转移,予以放化疗缓解。术后280例患者中,8例患者因肿块巨大一侧喉返神经受损术后出现声嘶,5例患者出现Horner’s综合征,11例患者出现血气胸、淋巴瘘等并发症。结论通过对280例颈根部周围神经手术入路和结果分析,良、恶性颈根部周围神经肿瘤手术治疗均有良好效果。

Objective To discuss the surgical approaches and indications of peripheral nerve tumors located in the root of neck.Methods Clinical data of 280 patients suffering from peripheral nerve tumors located in the root of neck and treated surgically in our hospital from 1995 to 2009 was analyzed retrospectively.Results Tumors in all cases were removed successfully.3 years＇ postoperative follow-up indicated that 10 of 221 benign cases recurred and one of them recurred in spinal cord which led to death.Meanwhile 16 of 59 malignant cases recurred locally or metastasized systemically.Some postoperative complications occurred,including hoarseness（8 cases）,Horner＇s syndrome（5 cases） and hemopneumothorax（11 cases）.Conclusion Surgical treatment is a good way to treat benign mass located in the root of neck and also has good effect for malignant tumor of peripheral nerve in this area.