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目的:发生于颈段椎管的神经鞘瘤可沿椎间孔向外生长,表现为颈椎内外交通性肿块,但多因早期出现脊髓压迫症状而就诊于神经外科。本文报告2例以颈部肿块为主要临床表现而就诊于口腔颌面外科的颈椎内外交通性神经鞘瘤,旨在提高临床医师对本病的诊断与治疗水平。方法:对中南大学湘雅医院口腔颌面外科近期收治的2例以颈部肿块为主要临床表现的颈椎内外交通性神经鞘瘤患者的临床资料进行总结与随访,并结合相关文献,探讨其临床病理特征、手术方式与预后。结果:2例患者均以颈上部肿块为主要症状就诊,术前影像学检查显示颈椎内外交通性哑铃型肿块,采用颈后正中和颈外侧联合入路切除肿瘤并重建脊柱的稳定性,随访1a未见复发。结论:发生于颈椎的神经鞘瘤可表现为颈部肿块而脊髓压迫症状并不明显,详细的体格检查与影像学检查可以明确诊断,手术切除具有一定难度。
OBJECTIVE: Schwannoma, occurring in the cervical canal, can grow out along the intervertebral foramen, which is characterized by internal and external cervical mass. However, many neurosurgeons are often diagnosed due to early symptoms of spinal cord compression. This article reports 2 cases of cervical mass as the main clinical manifestations of oral and maxillofacial surgery in the treatment of cervical and external traffic schwannoma, aimed at improving the clinician’s diagnosis and treatment of the disease. Methods: The clinical data of 2 cases with cervical mass as the main clinical manifestations of cervical and internal communicating schwannoma recently treated in Department of Oral and Maxillofacial Surgery, Xiangya Hospital of Central South University were summarized and followed up. The clinical data Pathological features, surgical methods and prognosis. Results: Two cases were treated with the upper cervical mass as the main symptom. The preoperative imaging examination showed that the dumbbell-shaped internal mass of the cervical spine was removed. The stability of the spine was removed by the combined approach of the posterior median neck and the lateral neck. No recurrence. Conclusion: Schwannoma occur in the cervical spine can be manifested as cervical mass and spinal cord compression symptoms are not obvious, a detailed physical examination and imaging studies can confirm the diagnosis, surgical resection has a certain degree of difficulty.