颌面颈部神经鞘瘤

Study on Shwannoma in the Jaws, Face and Neck.

目的 :总结临床经验以提高对神经鞘瘤的诊断治疗水平。方法 :对我院经治的 160例患者的诊治情况作回顾性研究。结果 :颌面部神经鞘瘤多见于青壮年 ,易累及颈动脉三角段交感神经干及迷走神经 ,确诊有赖于病理诊断。交感神经干及迷走神经易受损伤 ,完整摘除预后良好。结论 :宜在尽可能保留周围神经束枝的情况下钝性剥出肿瘤 ,对来源于迷走神经或位于颈动脉窦周围的神经鞘瘤 ,应在局部浸润麻醉下施术 。

Objective: Through review and follow-up of the in-patients with shwannoma to increase knowledge of diagnosis and treatment of the disease. Methods: The data of 160 cases with shwannoma in the jaws, faces and necks for 40 years from 1956～1995 were carefully reviewed and analysed, in which the cases after surgery for more than 10 years were followed up. Results: Shwannoma of the jaws, faces and necks were developing more in young and middle aged adults, involving more with vagus nerve and sympathic nerve located in the carotid triangle. Diagnosis of the disease was depended on pathological examination. Vagus nerve and sympathic nerve had more chance to be injured in the surgical operation. Prognosis was good after entire enucleation of the tumour. Conclusion: Blunt enucleation of the tumour should be performed under careful protection of the peripheral branches of the nerve. For the shwannoma from the vagus nerve and those located within carotid triangle, infiltration of local anesthetics immediately before the surgical procedure. was needed. To pay close attention to the general conditions of the patients was important to reduce severe complications. [