摘要
目的 :探讨头颈部神经鞘瘤的诊断、治疗及病理特点。方法 :回顾分析 4 9例头颈部神经鞘瘤患者的临床资料。其中男 18例 ,女 31例 ,2～ 73岁 ,肿瘤原发部位为咽旁 7例 ,颈侧 19例 ,鼻腔鼻窦 6例 ,鼓室、乳突 ,咽后壁、口底、牙龈各 2例 ,腮腺区、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。结果 :患者均行手术切除 ,术后病理确诊 ,良性 4 7例 ,恶性 2例。经随访 ,治愈 4 8例 ,复发 1例 ,经再次手术治愈。健在 4 7例 ,死亡 2例 ,1例恶性神经鞘瘤死于全身转移 ,1例良性肿瘤死于脑出血。结论 :手术切除是治疗本病的唯一方法 ;神经鞘瘤多为单发、包膜完整 ,易完整切除 ,但应尽量保留来源神经的完整性 ,如术中必须切除来源或受累神经 ,术后应予以即刻修复。影像学检查有助于了解病变范围、性质及选择术式 ;术前肿块针吸活检是确诊的重要手段 ,应列为常规。本病预后良好 ,倘若恶变 。
Objective:To improve the diagnosis and treatment of the neurilemmoma in head and neck. Method:The clinical main features,surgical finds and therapeutic effectiveness of 49 cases with neurilemmoma were reviewed and analyzed.Result:The patients were 9 in male,13 in female,aged 2 to 73 years.The primary positions of neurilemmoma were neck space in 19 cases,parapharyngeal space in 7 cases,nasal cavity and nasal sinuses in 6 cases,middle ear in 4 cases,retropharyngeal wall in 2 cases,gum in 2 cases, alvearium in 1 case,cheek in 1 case,prebase in 1 case,parotid region in 1 case,circumoral 2 cases,hypolarynx 1 case,submaxillary region 1 case,palate 1 case.All patients were cured by surgical treatment.After operation,neural functions of 45 cases were normal. Conclusion:Resection of this tumor is the only appropriate treatment.Described neurilemmoma of head and neck is uncommon.It has less neural function impairment,but it often appears as a tough,smooth and mobile mass.Surgical excision has no side effect on the neural function.Ultrasonography,CT and MR are helpful in limiting diagnostic hypothesis,but they don't show pathognomonic images.
出处
《山东大学基础医学院学报》
CAS
2002年第6期349-351,共3页
Journal of Preclinical Medicine College of Shandong Medical University
关键词
头颈部神经鞘瘤
病理学
临床
外科手术
病例分析
Head and neck neurilemmoma
Pathology,clinical
Surgery,otorhinolaryngologic
