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目的:总结颈部神经鞘瘤的诊断与治疗经验。方法:对25例颈部神经鞘瘤患者的临床资料进行回顾性分析,包括临床特点、影像学检查及手术方法。结果:磁共振成像(MRI)、电子计算机X射线断层扫描技术(CT)可显示瘤体与周围正常组织的关系;CT血管造影(CTA)是鉴别颈鞘内神经鞘瘤和颈动脉瘤的有效方法;MRI可清晰地显示瘤体与相关神经关系,对判断肿瘤的神经来源有重要作用。25例患者均行手术治疗,术后病理均符合良性神经鞘瘤,术后随访8个月至15年不等,肿瘤均无复发。术后并发症主要有声音嘶哑1例,Horner征3例,上肢运动功能障碍1例。结论:术前CT、CTA、MRI检查对提高颈部神经鞘瘤诊断的准确性及确定神经来源具有重要作用;手术切除是治疗神经鞘瘤唯一方法;对术中神经完整性受到破坏者可以在术中同期或术后二期行神经移植术。
Objective: To summarize the experience of diagnosis and treatment of cervical schwannoma. Methods: The clinical data of 25 cases of schwannoma of the neck were retrospectively analyzed, including clinical features, imaging examination and surgical methods. Results: Magnetic resonance imaging (MRI) and computed tomography (CT) showed the relationship between the tumor and the surrounding normal tissue. CT angiography (CTA) was an effective method to identify schwannoma and carotid aneurysm in the cervical sheath. Methods; MRI can clearly show the relationship between the tumor and related nerves, to determine the neural origin of the tumor has an important role. Twenty-five patients underwent surgical treatment. The pathological findings were all consistent with benign schwannoma. The patients were followed up for 8 months to 15 years. No recurrence was found in the tumors. Postoperative complications were mainly hoarseness in 1 case, Horner sign in 3 cases, upper extremity motor dysfunction in 1 case. Conclusion: Preoperative CT, CTA and MRI examination can improve the diagnostic accuracy of cervical schwannoma and determine the neural source. Surgical resection is the only method for treating schwannomas. Intraoperative or postoperative second phase of nerve grafting.