Lee E J, Calcaterra T C, Zuckerbraun L
Department of General Surgery, UCLA School of Medicine 90095, USA.
Ear Nose Throat J. 1998 Aug;77(8):670-4, 676.
An interesting case of a traumatic neuroma of the greater auricular nerve provides the impetus for a discussion of head and neck neuromas. Traumatic neuromas of the head and neck are relatively rare. Division of the greater auricular nerve during parotidectomy occasionally results in a traumatic neuroma. We report a case of a 73-year-old woman who presented with a traumatic neuroma nine years after undergoing superficial parotidectomy with dissection of the facial nerve for a mixed tumor. The patient had a 1.5 cm x 1.0 cm mass located below the old surgical site over the anteromedial border of the sternocleidomastoid muscle. The patient's past history was significant for Frey's syndrome, which is the result of abnormal neurologic growth. On first impression, the tumor was thought to be a recurrence of neoplastic disease; however, because of the evaluation, traumatic neuroma was suspected. An attempt at fine-needle aspiration of the mass was too painful to be carried out. At surgery, a whitish tumor was excised which, on final pathologic examination, revealed traumatic neuroma. The surgical literature is reviewed and the subject of head and neck neuromas, including their evaluation and management, is thoroughly discussed. Knowledge of this possible diagnosis may spare the patient and the surgeon needless worry, as well as unnecessary procedures, once tumor recurrence has been ruled out.
一例有趣的耳大神经创伤性神经瘤病例促使我们对头颈部神经瘤展开讨论。头颈部创伤性神经瘤相对少见。腮腺切除术中切断耳大神经偶尔会导致创伤性神经瘤。我们报告一例73岁女性患者，她在因混合瘤行面神经解剖的浅叶腮腺切除术后9年出现创伤性神经瘤。患者在胸锁乳突肌前内侧缘旧手术部位下方有一个1.5厘米×1.0厘米的肿块。患者既往有弗雷综合征病史，这是神经生长异常的结果。初诊时，该肿瘤被认为是肿瘤性疾病复发；然而，经过评估后，怀疑是创伤性神经瘤。对肿块进行细针穿刺的尝试因过于疼痛而未能实施。手术中切除了一个白色肿瘤，最终病理检查显示为创伤性神经瘤。本文回顾了外科文献，并对头颈部神经瘤的相关主题，包括其评估和处理进行了深入讨论。一旦排除肿瘤复发，了解这种可能的诊断可以避免患者和外科医生不必要的担忧以及不必要的操作。
