Clinical Analysis of Cervical Neurilemmoma

Baek, Seung Kuk; Choi, Jee Hoon; Kim, Seog Hyeon; Jun, Byung Sun; Woo, Jeong Su; Kwon, Soon Young; Jung, Kwang Yoon

Abstract

BACKGROUND AND OBJECTIVES
Neurilemmoma is a benign tumor originating from the spinal nerve root, peripheral nerve and all kinds of cranial nerves except the optic nerve and olfactory nerve. Approximately 25% to 40% of all neurilemmomas are found in the neural structures of the head and neck. We performed this study to analyze the clinical features, diagnosis, treatment and prognosis of neurilemmomas. SUBJECTS AND METHOD: Twenty-one patients who were diagnosed with cervical neurilemmoma and had received treatment at the Department of Otolaryngology-Head and Neck Surgeries from 1994 to 2004 were analyzed retrospectively. RESULTS: The mean age of 21 patients was 41.0 years, with 10 being male and 11 female. The most common symptom was palpable neck mass and the mean duration of symptoms was 28.2 months. The most common location of tumor was level II and the most common nerve of origin was the vagus nerve (23.8%). Preoperative diagnostic tools were FNA, CT and MRI. Operation was most commonly performed via transcervical approach. In 10 cases, nerves of origin were preserved, whereas, in 5 cases, nerves of origin were sacrificed and in 6 cases, nerves of origin were not found. The postoperative complications were vocal cord palsy (14.3%), arm weakness (14.3%), facial weakness (9.5%), Horner's syndrome (9.5%), sensory (4.8%) and motor (4.8%) impairment of tongue. The mean follow-up period was 5.3 years and recurrence was not found during this period. CONCLUSION: CT or MRI is more helpful than FNA in the diagnosis of neurilemmoma. In excising neurilemmoma, the nerve must be preserved as much as possible.