Maniglia A J, Chandler J R, Goodwin W J, Parker J C
Laryngoscope. 1979 Sep;89(9 Pt 1):1405-14. doi: 10.1002/lary.5540890905.
Schwannomas or neurilemmomas are among the most common neoplasms occupying the parapharyngeal space, yet only 107 cases have been previously reported. Neurilemmomas involving the jugular foramen are extremely rare. Only 55 cases have been reported in the world literature. The neoplasm occurred in the parapharyngeal space in three of our patients and in the jugular foramen in another patient. Of the tumors located in the parapharyngeal space, the nerve of origin in one of them was the glossopharyngeal, which is extremely rare. Adequate exposure for complete excision of parapharyngeal space tumors is best obtained through an external incision and should not be attempted transorally. In the jugular foramen case, the neoplasm arose from the vagus nerve high in the neck and extended intracranially in a "dumbbell" shape into the posterior cranial fossa. Total removal was successfully accomplished in one stage, by using a subtotal temporal bone resection--upper neck--posterior cranial fossa approach. Surgical removal is the treatment of choice. Schwannomas rarely recur following complete excision.
施万细胞瘤或神经鞘瘤是占据咽旁间隙的最常见肿瘤之一，但此前仅有107例病例报告。累及颈静脉孔的神经鞘瘤极为罕见。世界文献中仅报道了55例。我们的患者中有3例肿瘤发生在咽旁间隙，另有1例发生在颈静脉孔。在位于咽旁间隙的肿瘤中，其中1例的起源神经是舌咽神经，这极为罕见。完全切除咽旁间隙肿瘤的充分暴露最好通过外部切口获得，不应尝试经口切除。在颈静脉孔病例中，肿瘤起源于颈部高位的迷走神经，并以“哑铃”形向颅内延伸至后颅窝。通过颞骨次全切除 - 上颈部 - 后颅窝入路，一期成功完成了肿瘤全切。手术切除是首选治疗方法。施万细胞瘤在完全切除后很少复发。
