14例耳鼻咽喉头颈部神经鞘瘤临床分析

Clinical analysis of 14 cases of neurilemmoma in the otolaryngology-head and neck

目的探讨耳鼻咽喉头颈部神经鞘瘤的临床诊治方法及预后情况。方法回顾性分析我院收治的耳鼻咽喉头颈部神经鞘瘤患者的临床诊治及随访资料。结果 14例患者中颈侧区4例,舌部3例,颌下区、咽旁间隙、腭部、下唇、颏部、鼻腔及劈裂部位各1例。患者均行手术完整切除肿瘤。术后,有2例出现轻微声嘶,治疗后症状消失,无复发;有1例出现舌轻微偏斜,随访15个月后舌活动恢复正常,无复发;其余患者均未发生明显并发症,愈合良好,随访期间均无复发或其他不适。结论舌、唇、腭、鼻腔及咽喉等部位的神经鞘瘤术前易误诊,而颈侧区及咽旁间隙等部位的神经鞘瘤术前MRI诊断准确率较高。耳鼻咽喉头颈部神经鞘瘤采用手术完整切除,预后较好,少有复发。

Objective To explore the clinical diagnosis and treatment methods and prognosis of neurilemmoma in the otolaryngology-head and neck. Methods A retrospective analysis was made on the data of clinical diagnosis, treatment and follow-up of 14 patients with neurilemmoma in the ear, nose, throat, head and neck in our hospital. Results Of 14 patients, there were 4 cases in the lateral cervical region, 3 cases in the tongue, 1 case in the submandibular region, parapharyngeal space, pars palatalis, underlip, mental region, nasal cavity and cleavage of larynx. All patients underwent complete resection of the tumor by surgery. After surgery, 2 patients had mild hoarseness, and the symptoms disappeared after treatment, without recurrence. One patient had slight deviation of tongue, and the activity of tongue returned to normal and there was no recurrence after 15 months of follow-up. The rest of patients had no obvious complications and healed well. No recurrence or other discomfort occurred during the follow-up period. Conclusion Neurilemmoma in the tongue, lip, palate, nasal cavity and pharynx and larynx are easily misdiagnosed before operation, but the preoperative MRI diagnosis accuracy of neurilemmomas in lateral cervical region and parapharyngeal space are higher. The neurilemmomas in otolaryngology-head and neck are completely removed by surgery, and the prognosis is good, with little recurrence.