喉部神經鞘瘤

Neurilemmoma of the Larynx

神經鞘瘤 ( neurilemmoma) 起源於周邊神經的髓鞘細胞， 雖然在頭頸部並非罕見，但發生於喉部的病例卻相當少見。回顧文獻資料，喉部神經鞘膜瘤主要起源於杓會厭皺襞或假聲帶的位置。耳鼻喉科於2004年4月經歷一名56歲男性，主訴為無疼痛之輕微咽喉異物感持續數週，因而至本院求診。安排喉部內視鏡檢查，發現一大小為 0.5×0.5cm、圓球形、可移動的腫塊，位於右側杓會厭皺襞處。經喉內視鏡顯微手術切除腫瘤，病理報告為良性神經鞘瘤。術後於門診追蹤，患者症狀解除，且無復發現象。本病例因發生部位罕見，故提出報告，可作為鑑別診斷之參考。

Neurogenous tumors of the larynx are extremely uncommon. Neurilemmomas (Shwannomas) are benign peripheral nerve sheath tumors and rarely arise in the larynx. We present a rare case of a 56-year-old man who complained of persistant lumping sensation for 2 months. Flexible laryngoscopy showed a pale, ovoid, 0.5*0.5cmmass over right aryepiglottic fold of the larynx. It was excised completely by CO2 laser via LMS (laryngomicrosurgery). Pathological examination revealed the tumor was a neurilemmoma. No evidence of recurrence or neurologic deficits was noted. The keys of successful treatment of laryngeal neurogenic tumors are complete excision of the mass and preservation of laryngeal function.