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Diagnosis and Management of Extracranial Head and Neck Schwannomas: A Review of 27 Cases

机译:颅外头颈部神经鞘瘤的诊断和处理:附27例病例回顾。

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摘要

Objectives. Clinical records of 27 patients with extracranial head and neck schwannoma were retrospectively reviewed. Methods. Ultrasonography (US) was performed in all cases. Seven patients underwent CT. Twenty-five patients underwent MRI. Fine needle aspiration cytology (FNAC) was performed for 12 of the 27 patients. Clinical history, surgical data, and postoperative morbidity were analyzed. Results. The images of US showed a well-defined, hypoechoic, primarily homogeneous solid mass. At CT, only one of 7 cases (14%) was able to suggest the diagnosis of schwannoma. At MRI, twenty of 25 cases (80%) suggested the diagnosis of schwannoma. Only three of 12 cases (25%) displayed a specific diagnosis of schwannoma rendered on FNAC. The distribution of 27 nerves of origin was 10 (37%) vagus nerves, 6 (22%) sympathetic trunks, 5 (19%) cervical plexuses, 3 (11%) brachial plexuses, 2 (7%) hypoglossal nerves, and 1 (4%) accessory nerve. Complete tumor resection was performed in 11 patients, and intracapsular enucleation of the tumor was performed in 16 patients. The rate of nerve palsy was 100 (11/11) and 31% (5/16). Conclusions. MRI is sensitive and specific in the diagnosis of schwannoma. Intracapsular enucleation was an effective and feasible method for preserving the neurological functions.
机译:目标。回顾性分析27例颅外头颈部神经鞘瘤患者的临床记录。方法。在所有情况下均进行超声检查。 7例患者接受了CT检查。 25例患者接受了MRI。 27例患者中有12例进行了细针穿刺细胞学检查(FNAC)。分析临床病史,手术资料和术后发病率。结果。 US图像显示出清晰的,低回声的,基本均匀的固体。在CT上,只有7例中的1例(14%)能够提示神经鞘瘤的诊断。在MRI检查中,有25例中有20例(80%)建议诊断为神经鞘瘤。 12例病例中只有3例(25%)表现出对FNAC产生的神经鞘瘤的特异性诊断。 27条起源神经的分布是迷走神经10条(37%),交感神经干6条(22%),颈神经丛5条(19%),臂丛神经3条(11%),舌下神经2条(7%)和1条(4%)副神经。 11例患者进行了完整的肿瘤切除,16例患者进行了肿瘤的囊内摘除术。神经性麻痹的发生率分别为100(11/11)和31%(5/16)。结论。 MRI对神经鞘瘤的诊断具有敏感性和特异性。囊内摘除术是保留神经功能的一种有效可行的方法。

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