Le Mouel C, Angot A, Daurel P, Verdier M, Renon P, Suc B
Ann Otolaryngol Chir Cervicofac. 1980 Dec;97(12):1035-45.
Neurinoma of the vagus is a rare disease (less than a hundred cases published) and even more exceptional when it develops in the carotid cervical sulcus. Indeed, nevous tumors of the neck are usually situated in a high position, in the lateo-pharyngeal space. Clinical diagnosis is difficult: a chronical enlarged lymph node is the usual suggestion. Nevertheless, two signs, albeit inconsistent are very important: cough and bradycardia on palpation of the tumefaction. Enucleation, when possible, is the best procedure for exeresis, leaving the recurrent fibers intact. But in most cases, the tumor cannot be separated from the nervous fibers and the vagus nerve must be severed at both ends. This results in definitive paralysis of the homolateral vocal cord. Microscopically, it is not always easy to distinguish between neurofibroma and schwannoma because both tumors share a common cytogenetic origin and many intermediary forms are found. Only electronic microscopy can solve litigious cases. The importance of this distinction is not only speculative, a schwannoma assumes a solitary course but a neurofibroma may belong to Recklinghausen's disease. Both schwannoma and the rare solitary neurofibroma of the cervical portion of the vagus nerve can be surgically removed, their prognosis is favorable. nervous tumors of the neck in Recklinghausen's Disease must not be operated on account of possible aggravation.
迷走神经神经鞘瘤是一种罕见疾病（已发表病例不到100例），当其发生于颈动脉颈段沟时更为罕见。实际上，颈部神经肿瘤通常位于高位，即咽外侧间隙。临床诊断困难：通常提示为慢性肿大淋巴结。然而，有两个体征虽不恒定但非常重要：触诊肿物时出现咳嗽和心动过缓。若有可能，摘除术是切除的最佳方法，保留返神经纤维完整。但在大多数情况下，肿瘤无法与神经纤维分离，必须在两端切断迷走神经。这会导致同侧声带永久性麻痹。在显微镜下，区分神经纤维瘤和神经鞘瘤并不总是容易的，因为这两种肿瘤有共同的细胞遗传学起源，且发现有许多中间形式。只有电子显微镜能解决有争议的病例。这种区分的重要性不仅是理论上的，神经鞘瘤病程单一，但神经纤维瘤可能属于冯雷克林霍增氏病。迷走神经颈段的神经鞘瘤和罕见的孤立性神经纤维瘤都可通过手术切除，其预后良好。冯雷克林霍增氏病患者颈部的神经肿瘤因可能加重病情而不应进行手术。
