15例喉神经鞘瘤的临床分析  

Clinical analysis of 15 cases of laryngeal schwannoma

作　　者：姚丹丹 张鹏[1] 娄卫华[1] YAO Dandan;ZHANG Peng;LOU Weihua(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)

机构地区：[1]郑州大学第一附属医院耳鼻咽喉头颈外科,郑州450052

出　　处：《临床耳鼻咽喉头颈外科杂志》2021年第3期256-259,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨喉神经鞘瘤的临床特点和手术方式的选择。方法:15例喉神经鞘瘤患者中,肿瘤位于杓会厌皱襞4例,杓区4例,杓间区3例,室带2例,声带1例,声门下1例。所有患者均于全身麻醉下行喉部肿物切除术,其中4例经颈外入路切除肿瘤,11例经口入路切除肿瘤。结果:1例患者术后出现声音低沉;5例术后声嘶好转,但未完全恢复;1例随访至49个月因食管癌去世,随访期间未见复发;余8例未见异常。随访13~80个月,患者均未见原位复发及异位复发。结论:喉神经鞘瘤临床表现各异,一般预后良好。手术径路的选择与喉神经鞘瘤的部位及大小密切相关,若喉神经鞘瘤在内镜下暴露良好,可选择经口低温等离子切除肿瘤;对于声门下双侧神经鞘瘤,可分两次手术切除肿瘤,必要时可先行气管切开。Objective: To improve the diagnosis and treatment of laryngeal schwannoma. Methods: The clinical data of 15 patients with laryngeal schwannoma were retrospectively analyzed, including 5 male patients and 10 female patients. The tumors were located in aryepiglottic fold in 4 cases, arytenoid region in 4 cases, interarytenoid in 2 cases, false vocal cord in 2 cases, epiglottis in 1 case, vocal cord in 1 case, and subglottic region in 1 case. All patients underwent laryngeal mass resection under general anesthesia, including 4 cases of tumor resection by external approach and 11 cases of tumor resection by oral approach. Results: Following up for 13-80 months, 1 patient had low voice after operation. The hoarseness of 5 patients improved after operation, but not completely recovered. One patient died of esophageal cancer at 49 months of follow-up, and no recurrence was found during the follow-up period. The remaining 8 cases had no obvious abnormalities. Conclusion: The clinical symptoms of laryngeal schwannoma vary, and the prognosis is generally good. The choice of surgical path is closely related to the location and size of the laryngeal schwannoma. If the laryngeal schwannoma is well exposed under endoscopy, the tumor can be removed by transoral radiofrequency coblation. Schwannomas on both sides of the subglottic region can be resected by two surgeries, and the tracheotomy can be performed first if necessary.

关 键 词：喉肿瘤 神经鞘瘤 诊断 治疗 

分 类 号：R739.65[医药卫生—肿瘤]