颈前入路治疗颈部椎管外周神经源性肿瘤的体会  

Clinical experience of anterior cervical approaches in the treatment of cervical neurogenic tumor of the peripheral nerve

作　　者：董益鹏[1] 刘藏[1] 张晶[1] 侯瑞光[1] 张向华[1] 梅国顺[1] 王月平[1] 彭磊[1] 

机构地区：[1]首都医科大学附属北京友谊医院神经外科,100050

出　　处：《中华神经外科杂志》2017年第2期138-141,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨颈前手术入路治疗颈部不同部位的椎管外周神经源性肿瘤的临床疗效.方法 回顾性分析首都医科大学附属北京友谊医院神经外科2009年1月至2015年1月收治的22例颈部椎管外周神经源性肿瘤患者的临床资料.22例患者均行显微外科手术治疗,其中经颈前胸锁乳突肌前缘入路10例,经颈前胸锁乳突肌后缘入路4例,经颈前颌下咽后入路3例,经口腔入路2例,经锁骨上窝入路3例.结果 本组22例颈部椎管外周神经源性肿瘤均完整切除.术后有2例患者出现声音嘶哑,经神经营养药物对症治疗后症状改善.术后无一例患者出现脑脊液漏等其他并发症.术后随访12 ～84个月,平均随访（48.3±18.7）个月.1例患者术后1年复发,并再次行肿瘤切除术.结论 根据肿瘤部位的不同选用相应的颈前手术入路,对于治疗颈前部椎管外周神经源性肿瘤安全有效.Objective To investigate the clinical effect of using anterior cervical approaches in the treatment of cervical neurogenic tumor of the peripheral nerve from different parts.Methods A retrospective review of 22 cases of cervical neurogenic tumor of peripheral nerves was performed,who were admitted to Department of Neurosurgery,Beijing Friendship Hospital,Capital Medical University from January 2009 to January 2015.All 22 patients underwent microsurgical operations with anterior approach of sternocleidomastoid muscle in 10 cases,posterior approach of sternocleidomastoid muscle in 4 cases,anterior cervical retropharyngeal approach in 3 cases,trans-oral approach in 2 cases,and supraclavicular approach in 3 cases.Results The tumors in all 22 cases were totally resected.No surgical complications such as cerebrospinal fluid leakage were observed except 2 cases which developed hoarseness postoperatively that improved that after neurotrophic treatment.All cases were followed up for 12-84 month with a mean 48.3 ± 18.7 month.Recurrence occurred in 1 case which underwent 2nd operation.Conclusion It seems safe and effective to select appropriate approaches corresponding to various tumor locations in the treatment of cervical neurogenic tumors of peripheral nerves.

关 键 词：头颈部肿瘤 神经源性肿瘤 显微外科手术 治疗结果 

分 类 号：R739.4[医药卫生—肿瘤]