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15例喉神经鞘瘤的临床分析

[Clinical analysis of 15 cases of laryngeal schwannoma].

作者信息

Yao Dandan, Zhang Peng, Lou Weihua

机构信息

Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Mar;35(3):256-259. doi: 10.13201/j.issn.2096-7993.2021.03.014.

Abstract

To improve the diagnosis and treatment of laryngeal schwannoma. The clinical data of 15 patients with laryngeal schwannoma were retrospectively analyzed, including 5 male patients and 10 female patients. The tumors were located in aryepiglottic fold in 4 cases, arytenoid region in 4 cases, interarytenoid in 2 cases, false vocal cord in 2 cases, epiglottis in 1 case, vocal cord in 1 case, and subglottic region in 1 case. All patients underwent laryngeal mass resection under general anesthesia, including 4 cases of tumor resection by external approach and 11 cases of tumor resection by oral approach. Following up for 13-80 months, 1 patient had low voice after operation. The hoarseness of 5 patients improved after operation, but not completely recovered. One patient died of esophageal cancer at 49 months of follow-up, and no recurrence was found during the follow-up period. The remaining 8 cases had no obvious abnormalities. The clinical symptoms of laryngeal schwannoma vary, and the prognosis is generally good. The choice of surgical path is closely related to the location and size of the laryngeal schwannoma. If the laryngeal schwannoma is well exposed under endoscopy, the tumor can be removed by transoral radiofrequency coblation. Schwannomas on both sides of the subglottic region can be resected by two surgeries, and the tracheotomy can be performed first if necessary.

摘要

为提高喉神经鞘瘤的诊断与治疗水平。回顾性分析15例喉神经鞘瘤患者的临床资料,其中男性5例,女性10例。肿瘤位于杓会厌襞4例,杓区4例,杓间区2例,假声带2例,会厌1例,声带1例,声门下区1例。所有患者均在全身麻醉下行喉部肿物切除术,其中4例行外入路肿瘤切除术,11例行经口入路肿瘤切除术。随访13 - 80个月,1例术后出现声音低沉。5例患者术后声音嘶哑有所改善,但未完全恢复。1例患者在随访49个月时死于食管癌,随访期间未发现复发。其余8例无明显异常。喉神经鞘瘤的临床症状各异,预后一般良好。手术路径的选择与喉神经鞘瘤的位置和大小密切相关。若内镜下喉神经鞘瘤暴露良好,可经口行射频消融切除肿瘤。声门下区双侧的神经鞘瘤可分两次手术切除,必要时可先行气管切开术。

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本文引用的文献

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[Endoscope-assisted transoral resection of parapharyngeal space tumors: a retrospective study].[内镜辅助经口切除咽旁间隙肿瘤:一项回顾性研究]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Sep;34(9):824-827;835. doi: 10.13201/j.issn.2096-7993.2020.09.013.
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Laryngeal schwannoma: a systematic review.喉神经鞘瘤:一项系统评价
Eur Arch Otorhinolaryngol. 2017 Jan;274(1):25-34. doi: 10.1007/s00405-016-4013-6. Epub 2016 Mar 28.
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[Subglottic schwannoma misdiagnosed as bronchial asthma in one case].
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;50(6):511.
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