Ishida Ueha Rumi, Nishimura Shinichi, Nito Takaharu
Department of Otolaryngology, Kameda Medical Center, Chiba, Japan.
Auris Nasus Larynx. 2012 Jun;39(3):317-20. doi: 10.1016/j.anl.2011.07.010. Epub 2011 Aug 20.
Schwannomas of the larynx are rare. Furthermore, a laryngeal schwannoma extending to the neck region is extremely rare. The present case report describes a 37-year-old male patient with a history of hoarseness and cervical swelling on the left side for over 10 years. He presented with dyspnea on exertion. Fiberoptic laryngoscopy revealed a large submucosal mass in the left false and true vocal folds, and the left vocal fold was immobile. Magnetic resonance imaging revealed the presence of multiple tumors throughout the body, in addition to extension of the laryngeal tumor to the left neck region in a dumbbell shape. After analysis of the results of examinations including imaging tests and pathological examinations, a diagnosis of schwannomatosis was made. A tracheostomy was performed, along with resection of the laryngeal tumor. Following disarticulation of the cricothyroid joint and rotate ion of the thyroid cartilage, the intralaryngeal part of the tumor was smoothly removed without median or lateral thyrotomy. At the 3-month follow-up, the patient's vocal fold mobility was found to have recovered. Although uncommon, our procedure was very effective for the treatment of laryngeal schwannomas. By this approach, safe removal of the tumor was possible, without any injury to the laryngeal mucosa.
喉神经鞘瘤较为罕见。此外,延伸至颈部区域的喉神经鞘瘤极为罕见。本病例报告描述了一名37岁男性患者,有超过10年的声音嘶哑和左侧颈部肿胀病史。他出现活动时呼吸困难。纤维喉镜检查显示左侧真假声带处有一个大的黏膜下肿物,左侧声带固定不动。磁共振成像显示全身存在多个肿瘤,此外喉肿瘤呈哑铃状延伸至左侧颈部区域。在分析包括影像学检查和病理检查在内的各项检查结果后,诊断为神经鞘瘤病。进行了气管切开术,并切除了喉肿瘤。在环甲关节离断和甲状软骨旋转后,肿瘤的喉内部分顺利切除,未行甲状软骨正中或侧方切开。在3个月的随访中,发现患者声带活动度已恢复。尽管不常见,但我们的手术方法对喉神经鞘瘤的治疗非常有效。通过这种方法,可以安全地切除肿瘤,而不会对喉黏膜造成任何损伤。