Yoon Sung Ho, Kim Cha Soo, Oh Jae Wook, Lee Keun Cheol
Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Arch Craniofac Surg. 2020 Dec;21(6):380-383. doi: 10.7181/acfs.2020.00416. Epub 2020 Dec 20.
Schwannomas, which originate from Schwann cells in the peripheral nervous system, are slowgrowing and uncommon benign tumors. Most schwannomas (90%) occur in isolation, and multiple occurrences are a characteristic feature of neurofibromas. Schwannomas of the nose and nasal tip are particularly unusual. Although a few cases of schwannomas of the sinusoidal tract and nasal septum have been reported, schwannomas arising from the nasal dorsum area and tip are extremely rare. Sensory abnormalities are also a very rare symptom. We excised a schwannoma on the nasal dorsum through direct incision and a schwannoma on the nasal tip through open rhinoplasty. No postoperative complications involving recurrence, hematoma, or infection occurred. The possibility of neurological changes should be considered in cases of an abnormality in the peripheral nervous system. Schwannoma must be kept in mind as a possible cause of neurological changes localized to a specific dermatome, and should always be considered in the differential diagnosis of a mass on the nose.
神经鞘瘤起源于周围神经系统的施万细胞，是生长缓慢且罕见的良性肿瘤。大多数神经鞘瘤（90%）为单发，多发是神经纤维瘤的特征性表现。鼻及鼻尖部的神经鞘瘤尤为少见。虽然已有少数关于窦道和鼻中隔神经鞘瘤的病例报道，但起源于鼻背区域和鼻尖的神经鞘瘤极为罕见。感觉异常也是非常罕见的症状。我们通过直接切口切除了鼻背部的一个神经鞘瘤，并通过开放式鼻整形术切除了鼻尖部的一个神经鞘瘤。术后未发生涉及复发、血肿或感染的并发症。在外周神经系统出现异常的病例中，应考虑神经功能改变的可能性。神经鞘瘤必须被视为导致局限于特定皮节的神经功能改变的可能原因，并且在对鼻部肿物进行鉴别诊断时应始终予以考虑。
