[Protection of vagus nerve during the cervical vagal schwannoma resection and functional rehabilitation].

OBJECTIVE: To explore the clinical anatomy of vagal schwannoma and the methods to preserve the continuity of vagus nerve during tumor resection and postoperative functional rehabilitation methods of the nerve.

METHOD: To review 15 cases of vagal schwannoma from 2002.07 to 2011.08 treated in the Department of Otolaryngology, West China Hospital. The operative modality was to strip the tumor while keeping the Schwann membrane almost intact so that to protect the nerve fibers as much as possible. postoperative treatment included glucocorticoids, neurotrophic medication, as well as voice and swallowing rehabilitation.

RESULT: Among 15 cases of schwannoma patients, 3 cases (3/15) experienced hoarseness of voice with the ipsilateral vocal cord located at the median position 2 years after operation. 2 cases(2/15) experienced no obvious hoarseness of voice with vocal cords slight vibration when pronouncing and reached normal vocal cord movement 3 months after operation, 10 cases were healed without vocal cord complications, 7 cases (7/15) experienced choking during drinking and the symptom was gradually eliminated 1 3 months thereafter.

CONCLUSION: To carefully discern and preserve the vagal fibers during the operation of vagal schwannoma could eliminate postoperative hoarseness and choking. Protection of superior laryngeal nerve should be also brought to the forefront because it could affect the quality of swallowing and speaking.