Abstract：
Extracranial hypoglossal schwannoma is a rare tumor primarily treated with surgical excision. This article aims to highlight the potential for unexpected complications intraoperatively, such as cerebrospinal fluid leakage from skullbase to neck.
A previously healthy 23-year-old male presented with tongue numbness. Magnetic resonance imaging revealed a 17 × 20 mm nodular lesion adjacent to the cervical segment of the internal carotid artery. Surgical excision was scheduled due to suspicion of a neurogenic tumor.
Intraoperatively, despite careful handling, cerebrospinal fluid leakage was observed. Manipulation of the mass caused detachment of proximal nerve fibers, potentially indicating avulsion of the hypoglossal nerve from the brainstem or nearby. Clear fluid leakage from the skull base was also noted.
Thorough preoperative evaluation and patient education regarding potential complications are crucial. This article presents an unexpected complication encountered during surgical excision of extracranial hypoglossal schwannoma, emphasizing the need for awareness and preparedness in such cases.
A previously healthy 23-year-old male presented with tongue numbness. Magnetic resonance imaging revealed a 17 × 20 mm nodular lesion adjacent to the cervical segment of the internal carotid artery. Surgical excision was scheduled due to suspicion of a neurogenic tumor.
Intraoperatively, despite careful handling, cerebrospinal fluid leakage was observed. Manipulation of the mass caused detachment of proximal nerve fibers, potentially indicating avulsion of the hypoglossal nerve from the brainstem or nearby. Clear fluid leakage from the skull base was also noted.
Thorough preoperative evaluation and patient education regarding potential complications are crucial. This article presents an unexpected complication encountered during surgical excision of extracranial hypoglossal schwannoma, emphasizing the need for awareness and preparedness in such cases.
摘要：
背景：颅外舌下神经鞘瘤是一种罕见的肿瘤，主要通过手术切除治疗。本文旨在强调术中意外并发症的可能性，如从颅底到颈部的脑脊液漏。
方法：一名先前健康的23岁男性表现为舌头麻木。磁共振成像显示，颈内动脉颈段附近有17×20mm的结节性病变。由于怀疑神经源性肿瘤，计划进行手术切除。
结果：术中，尽管小心处理，观察到脑脊液漏。操纵肿块导致近端神经纤维脱离，可能表明舌下神经从脑干或附近撕脱。还注意到颅底有明显的液体渗漏。
结论：彻底的术前评估和关于潜在并发症的患者教育是至关重要的。本文介绍了颅外舌下神经鞘瘤手术切除过程中遇到的意外并发症，强调在这种情况下需要提高认识和做好准备。
方法：一名先前健康的23岁男性表现为舌头麻木。磁共振成像显示，颈内动脉颈段附近有17×20mm的结节性病变。由于怀疑神经源性肿瘤，计划进行手术切除。
结果：术中，尽管小心处理，观察到脑脊液漏。操纵肿块导致近端神经纤维脱离，可能表明舌下神经从脑干或附近撕脱。还注意到颅底有明显的液体渗漏。
结论：彻底的术前评估和关于潜在并发症的患者教育是至关重要的。本文介绍了颅外舌下神经鞘瘤手术切除过程中遇到的意外并发症，强调在这种情况下需要提高认识和做好准备。
