耳、鼻、喉和颈部神经鞘瘤

IF 0.1 Q4 SURGERY Surgical Techniques Development Pub Date : 2019-08-27 DOI:10.4081/std.2019.7550
N. Sathe, Sheetal Shelke, Ankur Pareek, K. Chavan
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引用次数: 0

摘要

神经鞘瘤是一种起源于神经鞘的良性肿瘤,具有潜在的恶性潜能。除了嗅觉神经和视神经外,所有的脑神经都会产生神经鞘瘤,因为嗅觉神经和视觉神经中没有许旺细胞。神经鞘瘤通常是无症状的,由于来源神经受到压迫而出现较晚。我们对19例由头颈部异常部位引起的神经鞘瘤进行了研究,这些神经鞘瘤的表现多种多样,在处理这些病例时面临挑战。这些病例详细提交给KEM医院耳鼻咽喉科,并进行了临床和放射学全面评估,以制定管理策略。头颈部神经鞘瘤是一种罕见的实体瘤,但应被视为单侧鼻腔肿块、腭部肿块、颈部前部和外侧肿块的鉴别诊断。术前神经起源可能并不总是清楚的,但应记住术后神经功能丧失的可能性。计算机断层扫描和磁共振成像等放射学调查在管理中发挥着关键作用。在非血管性颈部肿瘤的情况下,细针抽吸细胞学检查是至关重要的,但在神经肿瘤的诊断中准确性较低。切除肿瘤的组织病理学仍然是诊断的金标准。
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Schwannomas of ear, nose, throat and neck
Schwannoma is a benign tumour of nerve sheath origin with latent malignant potential. All cranial nerves can give rise to schwannoma except for olfactory and optic nerves, which are devoid of Schwann cell. Schwanommas are usually asymptomatic and present late owing to compression of nerve of origin. We present our study of 19 cases of schwannoma arising from unusual sites in head and neck, having varied presentation and the challenges faced in management of these cases. These cases presented in detail to the department of Ear, Nose and Throat, KEM Hospital, and were thoroughly evaluated clinically and radiologically to formulate a management strategy. Schwannoma of the head and neck is a rare entity but should be considered as differential diagnosis in unilateral nasal mass cases, palatal masses, anterior and lateral neck masses. Nerve of origin may not always be clear preoperatively but the possibility of postoperative loss of nerve function should be kept in mind. Radiological investigations like computed tomography scan and magnetic resonance imaging play a pivotal role in management. In case of nonvascular neck tumours, fine needle aspiration cytology is crucial but has low accuracy in the diagnosis of neural tumors. Histopathology of excised tumour remains the gold standard in diagnosis.
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