Schwannomas are benign nerve sheath tumors that originate from any anatomical site. Most schwannomas occur in the head, neck or limbs, but rarely occur in the retroperitoneal space. Furthermore, the schwannoma originating from the vagus nerve of retroperitoneal space is much rare. We experienced a case of retroperitoneal schwannoma of the vagus nerve. A 34-year-old male was refered to our hospital for the evaluation of abdominal mass on ultrasonography. Endoscopic examination revealed submucosal tumor-like lesion on high body of the stomach. Computed tomography (CT) revealed that the stomach was compressed by a solid tumor in the retroperitoneum. On exploratory laparotomy, this mass turned out to be a baseball sized mass in the retroperitoneal space. The mass was excised in an encapsulated state. Histological examination with immunohistochemical stains revealed a schwannoma of the vagus nerve.
Adult ; Cranial Nerve Neoplasms/*diagnosis ; English Abstract ; Humans ; Male ; Neurilemmoma/*diagnosis ; Retroperitoneal Space ; *Vagus Nerve ; Vagus Nerve Diseases/*diagnosis

Vocal cord paralysis is a comlex disorder which may result from numerous causes. It is often associated with trauma, disease in adjacent tissue, or a generalized neuroligical disorder. Laryngeal EMG is a useful technique for vocal cord paralysis. However it has not been used due to the uncertainties of normal human vocal cord physiology and the technical difficulties in performing these studies. We investigated the pathophysiology of vocal cord paralysis with laryngeal electromyography(LEMG). We studied 20 patients with idiopathic vocal cord paralysis. 6 patients were denervated in the cricothyroid(CT) and 6 patients in the thyroarytenoid(TA), and 3 patients in both CT and TA muscles. These indicated superior laryngeal neuropathy, recurrent laryngeal neuropathy, and proximal laryngeal or vagus neuropathy, respectively. LEMG proved to be a safe and effective procedure in the diagnosis of laryngeal neuropathy, and make it possible to use electromyography as a routine procedure in diagnosis laryngeal paralysis.
Diagnosis ; Electromyography* ; Humans ; Muscles ; Physiology ; Vagus Nerve Diseases ; Vocal Cord Paralysis* ; Vocal Cords*

OBJECTIVETo study the clinical characters, diagnosis, surgical outcomes and treatment strategies of vagal paraganglioma (VP).

METHODSA retrospective review was performed on 11 patients with VP confirmed by surgery and pathology between January 2000 and July 2010.

RESULTSAlthough the combined application of ultrasonography, enhanced computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA), the preoperative diagnostic accuracy rate was only 27.2%. All patients were managed by surgical resection (one malignant case with postoperative radiotherapy). All patients either had or developed a vagal palsy and additional cranial nerve or sympathetic nerve deficits were sustained in 8 patients after operation. With a median follow-up time of 41 months (range: 4 - 132 months), one case lost and the others survived without local recurrence or distant metastasis.

CONCLUSIONSVP are rare and liable to misdiagnose. For increasing the preoperative diagnosis rate of VP, the combined application of imaging tests is important and clinicians and radiologists should also enhance the awareness of this disease. Postoperative complications including nerve injury are inevitable and individual treatment is required.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Paraganglioma ; diagnosis ; surgery ; Retrospective Studies ; Vagus Nerve Diseases ; diagnosis ; surgery ; Young Adult

OBJECTIVETo analysis the clinical presentation, radiological findings, surgical techniques and outcomes of jugular foramen (JF) schwannomas.

METHODSWe reviewed our 10-year experience in the surgical treatment of 17 patients suffered from JF schwannomas in Hua Shan Hospital, Shanghai. A total of 8 males and 9 females with a mean age of 42 years underwent surgical procedures. A relative long period of 53-month symptomatic history was shown before surgery. The main clinical presentation are vertigo and hearing difficulty in 10 cases, atrophy of unilateral muscles of tongue in 9 cases, involvement of lower cranial nerve in 8 cases. The classification of tumors was type A (at cerebellopontine angle with minimal enlargement of the JF) in five cases, type B (JF with intracranial extension) in 3 cases, type C (extracranial tumors with JF extension) in 2 cases and type D (dumbbell-shaped with both intra-and extracranial components) in 7 cases.

RESULTSFar lateral approaches were used in 10 cases, retrosigmoid suboccipital approaches were used in 5 cases. Submandibular approaches were selected in other 2 cases. Gross total removal was achieved in 12 cases, and subtotal removal in 5 cases. Follow-up revealed marked improvement from preoperative symptoms in 9 cases and no additional deficits in 3 cases. 5 cases suffered from additional neurological deficits. There were two cases of temporary hoarseness and gradually improved within follow-up. Two patients suffered from swallowing problems as a new deficit. One patient had facial palsy.

CONCLUSIONSJF schwannomas can be surgically treated with relative good outcomes. Surgical approaches should be tailored according to the tumor extension.

Accessory Nerve Diseases ; diagnosis ; surgery ; Adolescent ; Adult ; Cranial Nerve Neoplasms ; diagnosis ; surgery ; Female ; Glossopharyngeal Nerve Diseases ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; surgery ; Retrospective Studies ; Vagus Nerve Diseases ; diagnosis ; surgery

Angiography, Digital Subtraction ; Cranial Nerve Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paraganglioma ; diagnosis ; diagnostic imaging ; surgery ; Vagus Nerve Diseases ; diagnosis ; diagnostic imaging ; surgery