Shrikrishna B H, Jyothi A C, Kulkarni N H, Mazhar Md Shafiuddin
Department of ENT and Head-Neck Surgery, Navodaya Medical College Hospital and Research Centre, Mantralayam Road, Raichur, Karnataka 584 103 India.
Indian J Otolaryngol Head Neck Surg. 2016 Jun;68(2):241-7. doi: 10.1007/s12070-015-0925-5. Epub 2015 Dec 16.
Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25 % of the cases, and may be associated with Von Recklinghausen's disease. Schwannomas are always a diagnostic dilemma as they are asymptomatic for long time and histopathology is the gold standard for diagnosis. The present study retrospectively analysed data of 4 patients with schwannomas and reviewed the literature on the subject. Retrospective study at ENT & Head and Neck Surgery Department of Navodaya Medical College, Raichur. Data of 4 patients between 2008 and 2014 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and associated nerve of origin (NOO) were evaluated. The patients' age ranged from 18 to 50 years. None of them had type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial plexus, vagus nerve, sympathetic chain and lingual nerve. The nerve of origin was identified based on intra-operative findings and post-operative neurological deficits. Tumour was removed by debulk operation with the preservation of NOO method. Schwannomas are generally benign, and rarely recur. An accurate preoperative workup with the identification of NOO is very important not only for a correct diagnosis, but also for surgical planning and informing the patient about the possible complications.
施万细胞瘤是起源于施万细胞的周围神经良性肿瘤。它们较为罕见，通常为单发，有清晰的包膜。仅25%的病例发生于头颈部区域，且可能与冯·雷克林豪森病相关。施万细胞瘤长期无症状，组织病理学是诊断的金标准，因此一直是诊断难题。本研究回顾性分析了4例施万细胞瘤患者的数据，并复习了该主题的文献。在赖丘尔纳沃代亚医学院耳鼻喉科及头颈外科进行回顾性研究。回顾了2008年至2014年期间4例患者的数据。研究了颈段施万细胞瘤的部位以及这些病例的术中、组织病理学和术后临床情况。评估了诊断方法、手术类型及相关起源神经（NOO）。患者年龄在18至50岁之间。他们均无I型神经纤维瘤病或冯·雷克林豪森病。受累神经包括臂丛神经、迷走神经、交感神经链和舌神经。根据术中发现及术后神经功能缺损确定起源神经。采用保留NOO方法的减瘤手术切除肿瘤。施万细胞瘤一般为良性，很少复发。准确的术前检查并识别NOO不仅对正确诊断很重要，而且对手术规划以及告知患者可能的并发症也非常重要。
