头颈部少见部位神经鞘瘤——附22例分析

Rare neurilemmoma of head and neck: analysis of 22 cases

目的探讨头颈部少见部位神经鞘瘤的诊断和治疗。方法回顾性分析1984～2001年收治的22例临床资料。 结果男9例,女13例,年龄2.5～73岁。肿瘤原发部位:鼻腔鼻窦6例,鼓室、乳突、咽后壁、牙龈各2例,腮腺区、口底、声门下气管、外耳道、舌根部、颊部、颌下区及腭部各1例。术前能确诊仅5例。全部病例均手术切除。术后病理确诊,良性21例,恶性1例。经随访,治愈21例,复发1例,经再次手术治愈。结论神经鞘瘤多为单发,包膜完整,易于完整切除,但应尽量保留神经的完整性,手术切除为其唯一治疗方法。影像学检查有助于了解病变范围、性质及选择术式。术前肿块针吸活检为确诊的重要手段,应列为常规。本病预后良好,倘若恶变,应按恶性肿瘤处理。

ObjectiveTo improve the diagnosis and treatment of the rare neurilemmoma in head and neck.Methods22cases of neurilemmoma were reviewed retrospectively.Results9 cases were male and 13 cases were female.The age was2.5～73 years old.The primary positions of neurilemmoma were nasal cavity and nasal sinues (6 cases),middle ear (4 cases),retropharyngeal wall(2 cases), gum(2 cases), alvearium(1 case),cheek(1 case), prebase(1 case),parotid region(1 case),circu-moral(1 case),hypolarynx(1 case),submaxillary region(1 case),palate(1 case).All patients were cured by surgical treatment.Afteroperation the neural function of 21 cases were normal.ConclusionsThe resection of tumor is an only appropriatetreatment. Surgical excision has no harmful effect on the neural function.