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Parapharyngeal vagal neurilemmoma extending to the jugular foramen

Published online by Cambridge University Press:  29 June 2007

Eiji Yumoto*
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
Koshiro Nakamura
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
Toshihiro Mori
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
Naoaki Yanagihara
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
*
Address for correspondence: Eiji Yumoto, M.D., Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime 791-02, Japan. Fax: 81-899-64-4613

Abstract

A large vagal neurilemmoma in a 33-year-old man is reported. He complained of slowly progressive palsy of the tongue on the left side. Weakness of soft palate movement was also noted. Magnetic resonance imaging (MRI) revealed a tumour in the left parapharyngeal space with partial extension to the posterior cranial fossa through the jugular foramen. Carotid angiography revealed avascularity of the tumour and anterior shift of the left internal carotid artery. The venous phase showed no blood flow in the internal jugular vein. The tumour was successfully extirpated via a transmandibular transpterygoid approach. Although vagus nerve dysfunction was not observed pre-operatively, the tumour was identified as a neurilemmoma arising from the vagus nerve. The surgical approach should be selected according to the lesion in individual patients. Since neurilemmoma is benign in nature, minimal post-operative sequelae should be expected.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1996

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