Wilson Matthew A, Hillman Todd A, Wiggins Richard H, Shelton Clough
Department of Surgery, Division of Otolaryngology--Head and Neck Surgery, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, U.S.A.
Laryngoscope. 2005 Aug;115(8):1486-92. doi: 10.1097/01.mlg.0000172196.76865.a1.
OBJECTIVES/HYPOTHESIS: To describe the presentation, radiographic findings, and surgical management of seven patients who have been diagnosed and treated with jugular foramen schwannomas at the University of Utah.
Retrospective chart review.
The charts of seven patients diagnosed with jugular foramen schwannomas were reviewed for presentation symptoms, radiographic findings, and physical examination findings. For the six who underwent surgical excision, the surgical procedure used, cranial nerve function results, audiometric results, perioperative complications, and other follow-up data are presented.
Seven patients were identified from ages 24 to 69 years. Six of the seven underwent surgical excision. Primary presentation symptoms included dizziness, hearing loss, dysphagia, diplopia, tongue paresis, and hoarseness. The choice of surgical approach was based on the size and location of the tumor. All patients had complete excision of their tumors. The nerve of origin included the glossopharyngeal, vagus, and spinal accessory nerves. Preoperative cranial nerve dysfunction continued postoperatively for lower cranial nerves but resolved in patients who were noted to have preoperative dysfunction of cranial nerve V and VI. The rate of new lower cranial nerve injury was 15% and was only seen in the cranial nerves that were determined to be the nerve of origin. In two cases, a temporary feeding tube was required. No recurrences have been noted to date.
Jugular foramen schwannomas can be successfully diagnosed preoperatively with computed tomography and magnetic resonance imaging. These tumors can be successfully managed with surgery and low morbidity.
目的/假设：描述在犹他大学被诊断并接受治疗的7例颈静脉孔神经鞘瘤患者的临床表现、影像学表现及手术治疗情况。
回顾性病历审查。
回顾7例被诊断为颈静脉孔神经鞘瘤患者的病历，以了解其临床表现、影像学表现及体格检查结果。对于接受手术切除的6例患者，介绍了所采用的手术方法、颅神经功能结果、听力测试结果、围手术期并发症及其他随访数据。
7例患者年龄在24至69岁之间。7例中有6例接受了手术切除。主要临床表现包括头晕耳鸣、听力丧失、吞咽困难、复视、舌肌麻痹和声音嘶哑。手术入路的选择基于肿瘤的大小和位置。所有患者的肿瘤均被完全切除。肿瘤起源神经包括舌咽神经、迷走神经和副神经。术前存在的颅神经功能障碍在术后仍存在于低位颅神经，但术前存在颅神经V和VI功能障碍的患者其功能障碍得到缓解。新的低位颅神经损伤发生率为15%，且仅见于被确定为起源神经的颅神经。2例患者需要临时放置饲管。迄今为止未发现复发情况。
颈静脉孔神经鞘瘤术前可通过计算机断层扫描和磁共振成像成功诊断。这些肿瘤可通过手术成功治疗，且发病率较低。
