Koscielny S, Sölch O
HNO-Klinik der Friedrich-Schiller-Universität Jena, Jena.
Laryngorhinootologie. 2008 Sep;87(9):647-50. doi: 10.1055/s-2007-995522.
Schwannoma of the vagal nerve are rare and usually accidentally found by exploring a slowly growing and painless neck tumor.
We report on a 49-year-old patient with an extensive schwannoma of the vagal nerve. The tumor grew from the brainstem to the lower neck vessel sheath and destroyed the skull base. The tumor had already involved all nerves of the foramen jugulare. The surgery was performed in cooperation with the neurosurgeons. Initially the cervical part of the tumor was removed by transcervical approach. Then the endocranial part of the tumor was removed by retrosigmoidal craniotomy and partial petrosectomy.
We have observed 5 schwannomas of the vagal nerve in 47,000 patients for 16 years. The diagnostic and therapeutic procedure is determined by the preoperative nerve function. In case of an intact nerve and after verifying the diagnosis of a schwannoma a detailed information given to the patient is absolutely necessary before any intervention. If the nerve lost its function there are no contraindications to resect the tumor and the nerve. Tumors with an intracranial extension should be treated interdisciplinarily (ENT/neurosurgery).
迷走神经鞘瘤罕见，通常在探查生长缓慢且无痛的颈部肿瘤时偶然发现。
我们报告一名49岁患有广泛迷走神经鞘瘤的患者。肿瘤从脑干生长至下颈部血管鞘并破坏颅底。肿瘤已累及颈静脉孔的所有神经。手术与神经外科医生合作进行。最初经颈部入路切除肿瘤的颈部部分。然后通过乙状窦后开颅术和部分岩骨切除术切除肿瘤的颅内部分。
我们在16年里对47000例患者观察到5例迷走神经鞘瘤。诊断和治疗程序取决于术前神经功能。在神经完整且确诊为神经鞘瘤的情况下，在任何干预之前向患者提供详细信息绝对必要。如果神经失去功能，切除肿瘤和神经没有禁忌证。有颅内扩展的肿瘤应采用多学科（耳鼻喉科/神经外科）治疗。
