Yumoto E, Nakamura K, Mori T, Yanagihara N
Department of Otolaryngology, Ehime University, Japan.
J Laryngol Otol. 1996 May;110(5):485-9. doi: 10.1017/s0022215100134061.
A large vagal neurilemmoma in a 33-year-old man is reported. He complained of slowly progressive palsy of the tongue on the left side. Weakness of soft palate movement was also noted. Magnetic resonance imaging (MRI) revealed a tumour in the left parapharyngeal space with partial extension to the posterior cranial fossa through the jugular foramen. Carotid angiography revealed avascularity of the tumour and anterior shift of the left internal carotid artery. The venous phase showed no blood flow in the internal jugular vein. The tumour was successfully extirpated via a transmandibular transpterygoid approach. Although vagus nerve dysfunction was not observed pre-operatively, the tumour was identified as a neurilemmoma arising from the vagus nerve. The surgical approach should be selected according to the lesion in individual patients. Since neurilemmoma is benign in nature, minimal post-operative sequelae should be expected.
报告了一名33岁男性的巨大迷走神经鞘瘤。他主诉左侧舌部进行性迟缓性麻痹。还注意到软腭运动无力。磁共振成像（MRI）显示左侧咽旁间隙有一肿瘤，部分经颈静脉孔延伸至后颅窝。颈动脉血管造影显示肿瘤无血管，左颈内动脉向前移位。静脉期显示颈内静脉无血流。通过经下颌经翼突入路成功切除肿瘤。虽然术前未观察到迷走神经功能障碍，但肿瘤被确定为起源于迷走神经的神经鞘瘤。应根据个体患者的病变选择手术入路。由于神经鞘瘤本质上是良性的，预计术后后遗症极少。
