舌下神经鞘瘤

目的提高舌下神经鞘瘤的诊治水平。方法报告４例病人的临床表现、诊断和手术结果，并复习文献。结果４例均有典型的病侧舌肌萎缩，Ｘ线断层摄像可见病侧舌下神经管扩大，ＭＲＩ可清晰显示肿瘤及其与周围结构的关系。４例分别经乙状窦后、枕下极外侧和颈部入路手术，３例肿瘤全切，１例大部切除。结论舌下神经鞘瘤罕见。按肿瘤累及范围，可分为颅内型、颅外型、颅内－外哑铃型和管内型四种。根据分型选择恰当的手术入路，肿瘤多能全切。

Hypoglossal schwannoma

Objective To improve the diagnosis and treatment of hypoglossal schwannoma. Methods The clinical manifestations, diagnosis and surgical results of 4 patients were reported. The literature was reviewed. Results Typical hemiatrophy of the tongue presented in all 4 patients. Special views of the skull, such as those afforded by tomograms revealed enlargement of the hypoglossal canal. MRI could demonstrated the exact extension of the tumor and its relationship to surrounding structures. The patients were operated on via retrosigmoid, extreme lateral suboccpital and cervical approaches respectively. The tumors were removed totally in three patients, and subtotally in one. Conclusion Hypoglossal schwannoma is extremely rare. It can be classified into intracranial, extracranial, intra and extracranial dumb bell shaped, and intracanalicular types based on its location. Most tumors can be totally removed via proper surgical approach.