경부에 발생하는 신경초종에서 수술적 치료와 정기적 경과관찰의 임상적 비교

Clinical Comparison of Surgical Treatment and Close Observation Without Surgery in the Management of Schwannomas in the Neck

  • 홍성룡 (서울대학교 의과대학 이비인후과학교실) ;
  • 정영호 (서울대학교 보라매병원 이비인후과) ;
  • 안수연 (서울대학교 의과대학 이비인후과학교실) ;
  • 하정훈 (서울대학교 의과대학 이비인후과학교실) ;
  • 성명훈 (서울대학교 의과대학 이비인후과학교실) ;
  • 김광현 (서울대학교 의과대학 이비인후과학교실)
  • Hong, Sung-Lyong (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Jung, Young-Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Hospital) ;
  • An, Soo-Youn (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Hah, J.-Hun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Sung, Myung-Whun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Kim, Kwang-Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
  • 발행 : 2009.05.22

초록

Backgrounds and Objectives : Most patients with neck schwannomas are asymptomatic. Surgical management of neck schwannomas could cause various complications. The aim of this study is to evaluate the necessity of surgical management in all of the neck schwannoma patients. Material and Methods : Thirty-four patients diagnosed and undergone surgical management as neck schwannomas and 30 patients diagnosed and observed closely by OPD base from 1996 to 2005 were included. The medical records were reviewed retrospectively. Results : In surgical management group, mean age was 39.3 years and mean size of tumors was 4.4cm. Twenty-five patients had their tumors at parapharyngeal space, 2 at anterior neck and 7 at lateral neck. Nerves of origin were vagus nerve in 12 patients, cervical sympathetic chain in 11. Presenting symptoms were neck mass in 22 patients and no symptom in 9. On the other hand, in close observation group, mean age was 47.1 years and mean size of tumor was 3.7cm. Seventeen patients had their tumors at parapharyngeal space, 5 at anterior neck and 8 at lateral neck. Presenting symptoms were neck mass in 13 patients and no symptom in 13. There were no patients with neurologic complications. Mean follow-up duration was 38.2 months and there were only 2 patients whose size of tumors was increased and no patients who had newly emerged symptoms. Conclusion : Neck schwannomas grows slowly, has little chance of malignant transformation, but can complicate serious problems after surgical management. Therefore close observation could be considered in many asymptomatic patients.

키워드

참고문헌

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