Neurilemmoma of the Parapharyngeal Space - Case Report

咽旁間隙（parapharyngeal space）是頸部的一個潛在空間，範圍由顱骨底部延伸至舌骨，介於咽縮肌（pharyngeal constrictors）與下頜骨（ramus of the mandible）與內翼肌（medial pterygoid muscle）之間。發生於此處的腫瘤實屬罕見，僅佔頭頸部腫瘤的0.5%。其中20-30%是屬於神經性腫瘤。位於咽旁間隙的神經鞘瘤少有明顯症狀，多由病人無意中或醫師在例行檢查中發現。本院1999年經歷1名38歲女性病人因吞嚥異物感求治，經檢查發現右側咽壁有一腫瘤，無伴隨神經症狀。進一步安排核磁共振造影（magnetic resonance imaging）發現腫瘤位在莖突前間隙（prestyloid compartment），懷疑是源自神經或唾液腺，採經頸手術法（transcervical）將腫瘤完整摘除，證實為神經鞘瘤。術後舌下神經受損，經1年追蹤；舌部功能已有代償現象，對吞嚥、說話無影響。且腫瘤亦無復發，目前仍門診複查中。

關鍵字

咽旁間隙腫瘤；神經鞘瘤；核磁共振造影；莖突前間隙

並列摘要

The parapharyngeal space (PPS) is a potential space that extends from the skull base to the hyoid bone and is bounded medially by the fascia surrounding the pharyngeal constrictor muscle and laterally by the ramus of the mandible and the medial pterygoid muscle. PPS neoplasms comprise only 0.5% of all head and neck tumors, and neurogenic tumors such as neurilemmomas, schwannomas or paragangliomas constitute only 30% of these PPS tumors. We report the case of a 38-year-old woman who on presentation complained of a foreign body sensation when swallowing and was without neurological abnormalities. She was found to have a submucosal growth on the right side of the oropharyngeal wall. A tumor was found in the prestyloid compartment of the PPS with magnetic resonance imaging (MRI). A well-encapsulated tumor was surgically excised via a transcervical approach and proved to be a neurilemmoma. Postoperatively, paralysis of the right side of the tongue developed. Follow-up examinations have showed gradual recovery without disease recurrence over six months of follow-up Based on radiological classification of a PPS tumor as either prestyloid or poststyloid, the clinician can formulate the most appropriate management plan. MRI is valuable as a routine study for the differentiation of PPS tumors.

並列關鍵字

parapharyngeal space tumor ； neurilemmoma ； magnetic resonance imaging ； prestyloid compartment

國際替代計量

Neurilemmoma of the Parapharyngeal Space - Case Report

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