Valentino J, Boggess M A, Ellis J L, Hester T O, Jones R O
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084, USA.
Laryngoscope. 1998 Jul;108(7):1009-13. doi: 10.1097/00005537-199807000-00011.
Neurilemomas are classically described as fusiform tumors that eccentrically displace the undisturbed neural fascicles. The authors seek to clarify the relationship of cervical neurilemomas to their nerve of origin and assess the functional outcome of surgical extirpation.
A retrospective review of clinical, intraoperative, and histopathologic data of six patients with cervical extracranial neurilemomas.
Additional histochemical staining of the pathologic specimens was performed to evaluate the tumor for neurites. A comprehensive literature review of cervical neurilemoma cases and meta-analysis of clinical outcomes in these cases were performed.
In the series of five consecutive cervical neurilemomas, only one was an eccentric mass pushing the undisturbed nerve aside. In the five other cases, excision of the neurilemoma required complete nerve excision. Neural elements traveling through the central portions of the tumor were clearly demonstrated histologically. Collective analysis of the literature on cervical neurilemomas revealed that although some cases allow nerve preservation, preservation of function is frequently poor.
This experience and that reported in the literature suggest that it is frequently impossible to preserve the function of the nerve of origin with surgical treatment of cervical neurilemomas.
神经鞘瘤通常被描述为梭形肿瘤，其偏心性地推移未受干扰的神经束。作者旨在阐明颈部神经鞘瘤与其起源神经的关系，并评估手术切除的功能结果。
对6例颈部颅外神经鞘瘤患者的临床、术中及组织病理学数据进行回顾性分析。
对病理标本进行额外的组织化学染色以评估肿瘤的神经突。对颈部神经鞘瘤病例进行全面的文献综述，并对这些病例的临床结果进行荟萃分析。
在连续的5例颈部神经鞘瘤中，只有1例是偏心肿块，将未受干扰的神经推向一侧。在其他5例病例中，神经鞘瘤的切除需要完全切除神经。组织学上清楚地显示有神经成分穿过肿瘤中央部分。对颈部神经鞘瘤文献的综合分析表明，尽管有些病例可以保留神经，但功能保留往往较差。
本研究经验及文献报道提示，手术治疗颈部神经鞘瘤时，通常无法保留起源神经的功能。
