Abstract
Objectives
To present a new concept of surgical procedure for total removal of cervical schwannomas with neural function preservation, and the outcomes of this procedure in a series of tumors, with special reference to postoperative function of the nerve of origin.
Methods
A retrospective case study of consecutive 18 patients seen from January 2003 to December 2007 who underwent inter-capsular resection of cervical schwanomas derived from the nerve of vagus, hypoglossus, sympathetic trunk, accesorius, etc. was performed. During the procedure, motor fibers were confirmed and located on the surface of the tumor using nerve stimulator. Avoiding motor fibers, nerve sheath (epineurium and perineurium) is cut with a scalpel and the true capsule of the tumor is recognized. By the dissection between nerve sheath and true capsule, tumor is completely removed. The senior author named this procedure “Inter-capsular resection.”
Results
All tumors were resected completely, being proven by pathological study. No motor function deficit resulted, but mild Horner's symptom was experienced in a case with the tumor of superior cervical ganglion origin. In a case of cervical plexus schwannoma, nerve fibers were seen in the tumor pathologically.
Conclusions
Cervical schwannoma can be totally removed by inter-capsular resection without postoperative motor function deficit.
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