目的:神经鞘瘤是常见的神经鞘瘤,可能发生在身体的任何地方。4%的头颈部神经鞘瘤发生在鼻腔,很少有颅内成分,使这些演讲极为罕见。此外,神经鞘瘤表现为非特异性影像学征象,只能通过组织病理学检查明确区分,导致误诊为各种鼻腔肿瘤。我们的目标是对有或没有颅内扩展的鼻窦神经鞘瘤的已发表文献进行综述,并提供其他病例陈述。
方法:使用PubMed数据库进行了文献综述,术语为“鼻窦神经鞘瘤,\"\"颅内,\"\"前颅底,\"和\"神经鞘瘤。“对结果进行了审查,和其他确定的病例被引用并纳入研究.纳入标准是任何神经鞘瘤颅内扩展的病例。没有排除标准。将审查数据汇编到Excel中,并用于数据分析和比较。此外,在我们的机构内进行了搜索,以确定更多的鼻窦神经鞘瘤病例。
结果:我们确定了17例伴颅内扩张的鼻窦神经鞘瘤,五个来自我们的机构,十二个来自文学。分析显示:8名女性(47%),9名男性(53%),9名患者出现头痛(53%),6例患者出现嗅觉缺失(35%),4例患者出现鼻塞(24%),2例患者无症状(12%)。平均年龄和中位数分别为39.4±10.1和40。为了治疗,4例患者行内镜切除(24%),11人接受了开颅手术(65%),2例患者的数据不可用。6例患者出现治疗后并发症,5例具有CSF渗漏(29%),1例具有血肿(6%)。
结论:我们确定并讨论了17例伴颅内扩展的鼻窦神经鞘瘤。我们希望我们的评论为临床医生在评估鼻和前颅底肿块时保持神经鞘瘤作为潜在差异提供了见解。
OBJECTIVE: Schwannomas are common nerve sheath tumors and may occur anywhere in the body. 4% of head and neck schwannomas occur in the sinonasal cavity, and fewer yet have an intracranial component, making these presentations extremely rare. Furthermore, schwannomas present with nonspecific imaging signs and can only be definitively differentiated via histopathologic
review, leading to misdiagnosis as various nasal tumors. We aim to conduct a
review of published literature on sinonasal schwannomas with and without intracranial extension and provide additional case representations.
METHODS: A literature
review was conducted using the PubMed Database with the terms \"sinonasal schwannoma,\" \"intracranial,\" \"anterior skull base,\" and \"schwannoma.\" Results were reviewed, and additional cases identified were referenced and included in the study. Inclusion criteria were any case with intracranial extension of the schwannoma. There were no exclusion criteria.
Review data was compiled into Excel and used for data analysis and comparison. Additionally, a search was done within our institution to identify additional cases of sinonasal schwannoma.
RESULTS: We identified 17 cases of sinonasal schwannoma with intracranial extension, five from our institution and twelve from literature. Analysis revealed: 8 females (47%), 9 males (53%), 9 patients presented with headaches (53%), 6 patients presented with anosmia (35%), 4 patients presented with nasal obstruction (24%), and 2 patients with no symptoms (12%). Mean age and median were 39.4 ± 10.1 and 40, respectively. For treatment, 4 patients underwent endoscopic resection (24%), 11 underwent craniotomy (65%), and data was unavailable for 2 patients. Post-treatment complications occurred in 6 patients, 5 had CSF leaks (29%) and 1 had a hematoma (6%).
CONCLUSIONS: We identified and discussed 17 cases of sinonasal schwannoma with intracranial extension. We hope our
review provides insight for clinicians to maintain schwannoma as a potential differential when evaluating nasal and anterior skull base masses.