A Franzen1, K Koegel. 1. Klinik für HNO-Krankheiten und Plastische Wiederherstellungs-Chirurgie, Katholisches Krankenhaus Essen-Werden.
Abstract
BACKGROUND: Neurinomas of the cranial nerves and the sympathetic trunk are rare benign tumors, and as such are rarely considered in differential diagnostics. Neither clinical criteria nor diagnostic imaging studies are usually conclusive. PATIENTS: We present a case report in which the problems of diagnosis, differential diagnosis, and surgical therapy are discussed. RESULTS: Preoperative diagnosis include clinical examination, B-mode sonography, CT, and MRI. A biopsy does not usually help verify the diagnosis. A Glomus tumor has to be excluded preoperatively. The therapy of choice is complete surgical removal of the tumor, with a good postoperative cure rate. The nerve of origin can be preserved in many cases. However, there are some cases in which temporary or permanent damage of the nerve cannot be avoided. Especially where parts of the vagus nerve require resection, autologous nerve grafts are indicated. CONCLUSIONS: A neurinoma should be considered in cases of an uncertain neck tumor. Problems for the surgeon may result from failure to inform patients about possible nerve lesions before therapy.
BACKGROUND:Neurinomas of the cranial nerves and the sympathetic trunk are rare benign tumors, and as such are rarely considered in differential diagnostics. Neither clinical criteria nor diagnostic imaging studies are usually conclusive. PATIENTS: We present a case report in which the problems of diagnosis, differential diagnosis, and surgical therapy are discussed. RESULTS: Preoperative diagnosis include clinical examination, B-mode sonography, CT, and MRI. A biopsy does not usually help verify the diagnosis. A Glomus tumor has to be excluded preoperatively. The therapy of choice is complete surgical removal of the tumor, with a good postoperative cure rate. The nerve of origin can be preserved in many cases. However, there are some cases in which temporary or permanent damage of the nerve cannot be avoided. Especially where parts of the vagus nerve require resection, autologous nerve grafts are indicated. CONCLUSIONS:A neurinoma should be considered in cases of an uncertain neck tumor. Problems for the surgeon may result from failure to inform patients about possible nerve lesions before therapy.