Öz
Özet
Amaç. Schwannomlar (neurilemmomlar) periferik, kranial ve otonomik sinirlerin kılıflarından kaynaklanan; çoğunluğu baş boyun bölgesinde olmak üzere vücudun her yerinde görülebilen nadir, soliter nörojenik tümörlerdir. Klinik olarak büyüme hızları yavaş olan bu tümörler sıklıkla boyunda asemptomatik kitleler olarak karşımıza çıkar. Yöntem. Bu çalışmada kliniğimizde 2004-2008 yılları arasında cerrahi eksizyon uygulanmış ve histopatoljik olarak benign schwannom tanısı konulmuş altı olgu retrospektif olarak literatür eşliğinde incelenmiştir. Bulgular. Tümoral kitle olguların; ikisinde lateroservikal, birinde parafarengeal, birinde premaksiller bölgede; birinde timpaniumda ve birinde de sert damakta lokalize idi. Kitlelerin nöronal kökeninin kaynağı incelendiğinde olguların; birinde servikal sempatik zincir, birinde inferior orbital sinir ve birinde de olduğu tespit edildi. Olguların tümünde cerrahi eksizyon sırasında sinir fonksiyonları tam olarak korunmuş olup; sinir greftlenmesine gereksinim duyulmamıştır. Sadece infraorbitalistensininden köken alan bir olguda postoperatif yüzde parestezi gelişmiştir. Sonuç. Bu çalışmada baş boyun bölgesindeki schwannomların tanısı, patolojik özellikleri, prognozları ve tedavi yaklaşımlarıtartışılmıştır.
Anahtar sözcükler: Nörofibromatozis 2, baş ve boyun tümörleri, tanı, klinik protokolleri
Abstract
Aim. Schwannomas (neurilemmomas) are solitary rare neurogenic tumors that originae from the sheath of peripheral, cranial or autonomic nerve cells. Schwannomas can be seen everywhere in he body but more-often they are located at the head and neck region. They grow slowly clinically and frequently manifest themselves as asymptomatic masses in the neck. Method. In this retrospectively study, six patients who suffer from benign schwannoma have been histopathologically diagnosed and operated in our clinic between 2004 and 2008. Results. Head and neck mass of these six patients were located at the laterocervical region in two patients.and and at the parapharyngeal region, tympanium, premaxillary region and hard palate in the remaining four patients respectively. The neural origins of the masses were cervical sympathetic chain in one, inferior orbital nerve in one and nnervus tympanicus in another. The functions of the nerves were fully preserved during surgical excision of these six cases via conservative approaches, thus no nerve grafting was needed. Only in one case facial paresthesia that originated from the infraorbital nerve developed postoperatively. one of the mass which was Conclusion. In this study the diagnosis, pathological characteristics, treatment and prognosis of head and neck schwannoma is discussed.
Keywords: Neurofibromatosis 2, head and neck neoplasms, diagnosis, clinical protocolsAnahtar Kelimeler
Nörofibromatozis 2 baş ve boyun tümörleri tanı klinik protokolleri
Kaynakça
- Anadolu Y, Tatlıpınar AU, Gerçeker M, Aytaç S. Servikal vagustan köken alan kistik schwannoma. K.B.B. ve BBC Dergisi 2001; pp: 121-4.
- Stout AP. Tumors of the peripheral nervous system. J Missouri state med assoc 1949; 46; 255-9.
- Kriakos M. Pathology of selecred soft tissue tumors of the head and neck. Tumors of the Head and Neck: Clinical and pathological considerations’da. Ed. Batsakis JG. 2. baskı. Baltimore, William&Wilkins 1979: 1254-6.
- Diaz DD, Kennedy KS, Parker GS, White VJ. Schwannoma of the submandibular gland. Head Neck 1991; 13: 239-42.
- Hornick P, John LC, Murray A, Davis S, Croft RJ, Lumley JS. Neurilemmoma as a cause of combined thoracic outlet and Horner’s syndrome. Thorac cardiovasc Surg 1991; 39: 232-3.
- Park CS, Suh KW, Kim CK. Neurilemmomas of the cervical vagus nerve. Head Neck 1991; 13: 439-41.
- Arıkan OK, Tuna EÜ, Koç C, Özdem C. Baş ve Boyun schwannomları. Türk Otolarengoloji Arşivi 2002; 40: 30-5.
- Chang SC, Schi YM. Neurilemmoma of the vagus nerve. A case report and brief literature review. Laryngoscope 1984; 94: 946-9.
- Mukherjee DK. Neurilemmoma of the Vagus Nerve: A Case Report. J Laryngol otol 1979; 93: 187-92.
- Zhang H, Cai C, Wang S, Liu H, Ye Y, Chen X. Extracranial head and neck schwannomas: a clinical analysis of 33 patients. Laryngoscope 2007; 117: 278- 81.
- Hood RJ, Reibel JF, Jensen ME, Levine PA. Schwannoma of the cervical sympathetic chain. The Virginia experience. Ann Otol Rhinol Laryngol 2000; 109: 48-51.
- Toriumi DM, Atiyah RA, Murad T, Sisson GA Sr. Extracranial neurogenic tumors of the head and neck. Otolaryngol Clin North Am 1986; 19: 609-17.
- Batsakis JG. Tumors of the peripheral nerveus system. Tumors of the Head and Neck ‘de. Ed. Batsakis JG.4.Baskı. Baltimore, Williams&Wilkins 1974; 231-49.
- Rosen FS, Pou AM, Quinn FB Jr. Obstructive supraglottic schwannoma: a case report and review of the literature. Laryngoscope 2002; 112: 997-1002.
- Sakao T, Noguchi S, Murakami N, Uchino S. Neurilemmoma of the neck; a report of 35 cases. Nihon Geka Gakkai Zasshi 1990; 91: 407-10.
- Cabbarpur C, Büyüklü F, Çakmak Ö, Öztop İ, Özlüoğlu LN. Servikal sempatik zincirden kaynaklanan schwannom: Vaka Takdimi. Türk Otolarengoloji Arflivi 2002; 40: 153-6.
- Hawkins DB, Luxford WM. Schwannomas of the head and neck in children. Laryngoscope 1980; 90: 1921-6.
- Cohen LM, Schwartz AM, Rockoff SD. Benign Schwannomas: Pathologic Basis for CT Inhomogeneities. AJR Am J Roentgenol 1986; 147: 141-3.
- Colreavy MP, Lacy PD, Hughes J, Bouchier-Hayes D, Brennan P, O'Dwyer AJ, Donnelly MJ, Gaffney R, Maguire A, O'Dwyer TP, Timon CV, Walsh MA .Head and neck schwannomas--a 10 year review. J Laryngol Otol 2000; 114: 119-24.
- Çelikkanat MS, Pata YS, Turgut S, Dağlı Ş, Doğan H, Özdem C. Nervus accessorius schwannomu. KBB ve Baş Boyun Cerrahisi Dergisi 1996; 4: 184-6.
Öz
Kaynakça
- Anadolu Y, Tatlıpınar AU, Gerçeker M, Aytaç S. Servikal vagustan köken alan kistik schwannoma. K.B.B. ve BBC Dergisi 2001; pp: 121-4.
- Stout AP. Tumors of the peripheral nervous system. J Missouri state med assoc 1949; 46; 255-9.
- Kriakos M. Pathology of selecred soft tissue tumors of the head and neck. Tumors of the Head and Neck: Clinical and pathological considerations’da. Ed. Batsakis JG. 2. baskı. Baltimore, William&Wilkins 1979: 1254-6.
- Diaz DD, Kennedy KS, Parker GS, White VJ. Schwannoma of the submandibular gland. Head Neck 1991; 13: 239-42.
- Hornick P, John LC, Murray A, Davis S, Croft RJ, Lumley JS. Neurilemmoma as a cause of combined thoracic outlet and Horner’s syndrome. Thorac cardiovasc Surg 1991; 39: 232-3.
- Park CS, Suh KW, Kim CK. Neurilemmomas of the cervical vagus nerve. Head Neck 1991; 13: 439-41.
- Arıkan OK, Tuna EÜ, Koç C, Özdem C. Baş ve Boyun schwannomları. Türk Otolarengoloji Arşivi 2002; 40: 30-5.
- Chang SC, Schi YM. Neurilemmoma of the vagus nerve. A case report and brief literature review. Laryngoscope 1984; 94: 946-9.
- Mukherjee DK. Neurilemmoma of the Vagus Nerve: A Case Report. J Laryngol otol 1979; 93: 187-92.
- Zhang H, Cai C, Wang S, Liu H, Ye Y, Chen X. Extracranial head and neck schwannomas: a clinical analysis of 33 patients. Laryngoscope 2007; 117: 278- 81.
- Hood RJ, Reibel JF, Jensen ME, Levine PA. Schwannoma of the cervical sympathetic chain. The Virginia experience. Ann Otol Rhinol Laryngol 2000; 109: 48-51.
- Toriumi DM, Atiyah RA, Murad T, Sisson GA Sr. Extracranial neurogenic tumors of the head and neck. Otolaryngol Clin North Am 1986; 19: 609-17.
- Batsakis JG. Tumors of the peripheral nerveus system. Tumors of the Head and Neck ‘de. Ed. Batsakis JG.4.Baskı. Baltimore, Williams&Wilkins 1974; 231-49.
- Rosen FS, Pou AM, Quinn FB Jr. Obstructive supraglottic schwannoma: a case report and review of the literature. Laryngoscope 2002; 112: 997-1002.
- Sakao T, Noguchi S, Murakami N, Uchino S. Neurilemmoma of the neck; a report of 35 cases. Nihon Geka Gakkai Zasshi 1990; 91: 407-10.
- Cabbarpur C, Büyüklü F, Çakmak Ö, Öztop İ, Özlüoğlu LN. Servikal sempatik zincirden kaynaklanan schwannom: Vaka Takdimi. Türk Otolarengoloji Arflivi 2002; 40: 153-6.
- Hawkins DB, Luxford WM. Schwannomas of the head and neck in children. Laryngoscope 1980; 90: 1921-6.
- Cohen LM, Schwartz AM, Rockoff SD. Benign Schwannomas: Pathologic Basis for CT Inhomogeneities. AJR Am J Roentgenol 1986; 147: 141-3.
- Colreavy MP, Lacy PD, Hughes J, Bouchier-Hayes D, Brennan P, O'Dwyer AJ, Donnelly MJ, Gaffney R, Maguire A, O'Dwyer TP, Timon CV, Walsh MA .Head and neck schwannomas--a 10 year review. J Laryngol Otol 2000; 114: 119-24.
- Çelikkanat MS, Pata YS, Turgut S, Dağlı Ş, Doğan H, Özdem C. Nervus accessorius schwannomu. KBB ve Baş Boyun Cerrahisi Dergisi 1996; 4: 184-6.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 6 Şubat 2012 |
| Yayımlandığı Sayı | Yıl 2012Cilt: 34 Sayı: 3 |