경정맥공 신경초종
Schwannomas of the Jugular Foramen
소속 상세정보
김태선
정신/강삼석/이정길/김재휴/김수한/이제혁/김태선/정신
KMID : 0359819980270040488
Abstract
서론
경정맥공에서 발생하는 신경초종은 매우 드물며, 원발성 뇌종양의 약 8%정도를 차지하는
두개강내 신경초종의 약 2.9%를 차지하며 지금까지 약 120례 정도가 문헌에 보고되어졌다
경정맥공을 지나는 뇌신경들에서 종양이 발생하지만 대부분 정확하게 어떤 신경에서 종양
이 발생하는지는 구별이 힘들다. Sweasey등은 설인신경에서 대부분 종양이 발생한다고 보
고하였다. 임상증상이나 방사선학적 소견상 경정맥사구종이나 청신경초종과 구별이 힘들지
만 자기공명영상 촬영이나 bone setting CT 혈관조영술로 수술전 어느 정도 감별이 가능하
며 종양이 경정맥공에서 확장하는 정도에 따라 수술접근법이 달라진다.
본 병원 신경외과학교실에서는 경정맥공에서 발생한 신경초종 4례를 수술 체험하여 좋은
결과를 얻었기에 문헌고찰과 함께 보고한다.
#초록#
We describe four cases of schwannoma of the jugular foramen in which surgery was
performed in the Department of Neurosurgery, Chonnam University Hospital. Three
patients were men and one was a woman, and their mean age was 42.5 years. Patients
with neurofibromatosis were excluded from our study and the records of the four
patients were retrospectively reviewed with regard to clinical features, diagnosis, and
management. The initial symptom were hoarseness, headache and tinnitus. Computed
tomography, magnetic resonance imaging and cerebral angiography were found to
provide the best preoperative localization and differential diagnosis of these lesions, and
allowed better planning of the surgical approach. In three cases the tumor was
dumbbell-shaped, with both an intra- and extracranial component ; surgery involved a
combination of the lateral suboccopital infralabyrinthine and neurosurgical-otological
approach. The other tumor was located primarily at the cerebellopontine angle with
minimal enlargement of the jugular foramen ; surgical resection involved a retrosigmoid
suboccipital craniectomy.
The aim of surgery was total extension of the tumor, and this was achieved in all
cases. There was no operative mortality or major morbidity. Postoperative complication
were lower cranial nerve deficit, including swallowing difficulty, hoarseness and transient
facial nerve palsy and aspiration pneumonia, though improvement was noted within a
few months. In all cases, the outcome was good ; the follow-up period fanged from 6 to
30(mean 15) months and MRI imaging showed no tumor recurrence.
키워드
Jugular foramen; Schowannoma; Retrosigmoid craniectomy.;
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