Türk Nöroşirürji Dergisi 1999 , Vol 9 , Num 3
Murat KUTLAY1, Ahmet ÇOLAK1, Osman Niyazi AKIN1, Nusret DEMİRCAN1, Kenan KIBICI1, Kıvanç TOPUZ1, Çınar BAŞEKİM2, Dilaver DEMİREL3
1GATA Haydarpaşa Eğitim Hastanesi, Nöroşirüji Kliniği
2GATA Haydarpaşa Eğitim Hastanesi, Radyoloji Kliniği
3GATA Haydarpaşa Eğitim Hastanesi, Patoloji Kliniği
Peripheral nerve schwannomas are benign tumors originating from the Schwann's cells. In this study, our 13-year experience with surgical management of these rare tumors are presented and the concepts of treatment are discussed. Twenty-one patients undervent operations for removal of 22 peripheral nerve schwannomas from September 1, 1985 to June 6, 1998 at our clinic. Our series included 14 male and 7 female patients with an average age at presentation of 43.8 (range 19-65) years. Sixteen (72.7 %) of the 22 schwannomas had presented with pain in the distribution of the involved nerve. Postoperatively, 12 (75 %) had complete resolution, two (12.5 %) had partial resolution, one (6.25 %) had no change in the severity of his pain, and one (6.25 %) had increased pain. Of 15 patients (68.1 %) with preoperative weakness, seven (46.6 %) improved, six (40.0 %) were unchanged, and two (13.3 %) worsened. In the group of 7 (31.8 %) patients who had normal strenght preoperatively, six (85.7 %) maintained full strenght and one (14.2 %) decreased to a grade of 4/5. Three patients (13.6 %) who had incomplete resection of their tumors, developed recurrent tumors. Four patients (18.1 %) required graft repair of nerves. The mean follow-up duration was 29.4 (range:5-72) months. As a conclusion, it is possible to resect these tumors with no or minimal neurologic deficit and the complete excision of these lesions can be easily achieved by using a fascicular dissection technique. Even if, there are no neurological findings they should be surgically excised in the early period, because motor recovery is related to the degree of the preoperative motor deficit. Anahtar Kelimeler : Neural sheath, neurilemmoma, peripheral nerve, schwannoma