耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
臨床
喉頭神経鞘腫例
塩野 弘晶寺田 友紀宇和 伸浩貴田 紘太篠田 裕一朗山根木 康嗣都築 建三
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2023 年 116 巻 9 号 p. 899-905

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We encountered a rare case of schwannoma of the larynx. A 42-year-old man who had suffered from hoarseness for 13 years had been found by laryngoscopy 7 years ago as having a submucosal tumor in the left arytenoid region of the larynx. The tumor was removed transorally via laryngoscopy. The histopathological diagnosis was schwannoma. Two years later, the patient complained of a foreign body sensation in the larynx and pharynx, and laryngoscopy revealed a smooth mass in the left arytenoid region, suggesting recurrence of the schwannoma. CT and T1-weighted MRI showed a well-defined enhancing lesion measuring 32 × 23 × 20 mm in size without invasion in the left arytenoid region of the larynx. For the treatment, since it was a recurrent case, we selected an external approach to ensure complete removal of the tumor. The left laryngeal schwannoma excision was performed via a suprahyoid approach and tracheostomy were performed under general anesthesia. The histopathological diagnosis was schwannoma Antoni type A and B. With this surgery, the hoarseness improved without dysphonia, although the dysphagia was prolonged. The results of fiberoptic endoscopic evaluation of swallowing and the clinical course of dysphagia suggested that the dysphagia, it was derived from the inner branch of the superior laryngeal nerve. The dysphagia improved 2 months after the surgery. No recurrence has been observed for 4 years since the surgery.

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