Sandler Mykayla L, Sims John R, Sinclair Catherine, Sharif Kayvon F, Ho Rebecca, Yue Lauren E, Téllez Maria J, Ulkatan Sedat, Khorsandi Azita S, Brandwein-Weber Margaret, Urken Mark L
THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York.
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Head Neck. 2019 Jul;41(7):2450-2466. doi: 10.1002/hed.25758. Epub 2019 Apr 7.
Schwannomas, benign tumors arising from neurolemmocytes, are the most common type of peripheral nerve tumors. Extracranial schwannomas are most often found in the parapharyngeal space, commonly involving the vagus nerve to cervical sympathetic trunk. Vagal schwannomas present several unique clinical and therapeutic challenges.
A comprehensive literature review was conducted on 197 articles reporting 235 cases of cervical vagal schwannomas. Presenting symptoms, treatment approach, and postoperative outcomes were recorded and analyzed.
Vagal schwannomas commonly present as asymptomatic neck masses. When they become symptomatic, surgical resection is the standard of care. Gross total resection is associated with higher postoperative morbidity compared to subtotal resection. Initial reports using intraoperative nerve monitoring have shown improved nerve preservation. Recurrence rates are low.
The combination of intermittent nerve mapping with novel continuous vagal nerve monitoring techniques may reduce postoperative morbidity and could represent the future standard of care for vagal schwannoma treatment.
施万细胞瘤是起源于神经膜细胞的良性肿瘤，是最常见的周围神经肿瘤类型。颅外施万细胞瘤最常发生于咽旁间隙，通常累及迷走神经至颈交感干。迷走神经施万细胞瘤存在一些独特的临床和治疗挑战。
对197篇报道235例颈迷走神经施万细胞瘤的文章进行了全面的文献综述。记录并分析了临床表现、治疗方法及术后结果。
迷走神经施万细胞瘤通常表现为无症状的颈部肿块。出现症状时，手术切除是标准治疗方法。与次全切除相比，全切除术后发病率更高。最初使用术中神经监测的报告显示神经保留情况有所改善。复发率较低。
间歇性神经定位与新型连续迷走神经监测技术相结合可能会降低术后发病率，并且可能代表迷走神经施万细胞瘤治疗的未来标准治疗方法。
