颈部神经鞘瘤25例的诊断与治疗  

Diagnosis and treatment of cervical neurilemmoma in 25 cases

作　　者：杨旭[1] 孙兆瑶[1] 

机构地区：[1]常州市第一人民医院口腔科,江苏常州213000

出　　处：《现代医学》2017年第5期701-703,共3页Modern Medical Journal

摘　　要：目的:总结颈部神经鞘瘤的诊断与治疗经验。方法:对25例颈部神经鞘瘤患者的临床资料进行回顾性分析,包括临床特点、影像学检查及手术方法。结果:磁共振成像(MRI)、电子计算机X射线断层扫描技术(CT)可显示瘤体与周围正常组织的关系;CT血管造影(CTA)是鉴别颈鞘内神经鞘瘤和颈动脉瘤的有效方法;MRI可清晰地显示瘤体与相关神经关系,对判断肿瘤的神经来源有重要作用。25例患者均行手术治疗,术后病理均符合良性神经鞘瘤,术后随访8个月至15年不等,肿瘤均无复发。术后并发症主要有声音嘶哑1例,Horner征3例,上肢运动功能障碍1例。结论:术前CT、CTA、MRI检查对提高颈部神经鞘瘤诊断的准确性及确定神经来源具有重要作用;手术切除是治疗神经鞘瘤唯一方法;对术中神经完整性受到破坏者可以在术中同期或术后二期行神经移植术。Objective： To summarize the experience on clinical diagnosis and treatment for cervical neurilemmoma. Methods： The clinical data of 25 cases of cervical neurilemmoma were retrospectively analyzed, including clinical characteristics ,imageological examination and operation. Results： MRI, CT could show the relationships between the tumor and it＇s surrounding tissues. CTA was an effective method for the diagnosis of neurilemmoma in carotid sheath. MRI could clearly show the connection between the tumor and the relevant nerves and it was very helpful in determining the source of tumor. All the patients underwent surgical resection, the postoperative diagnosis was benign neurilemmoma by pathological examinations. During 8 months to 15 years follow-up, there were no recurrences. The postoperative complications included hoarseness （ 1 case）, Homer syndrome （3 cases ） and upper limb dysfunction （ 1 case）. Conclusion： CT, CTA, MRI are useful for the diagnosis of cervical neurilemmoma and they can offer valuable information about the origination. Surgical resection is the most effective treatment available for neurilmmoma. For the patients who suffered from compromised neural integrity during the surgery, they are suggested to have the reinnervation simultaneously or the two-stage operation.

关 键 词：神经鞘瘤 诊断 治疗 

分 类 号：R782[医药卫生—口腔医学]