Surgical resection of cervical schwannoma with the use of Narrow Band Imaging

Abstract

Various efforts have been made to avoid post-surgical neurological deficits in the resection of cervical schwannoma. We have experienced many cases, but regarding sympathetic nerve-derived tumors, we sometimes have difficulties in identifying the nerve pathways on the epineurium even when using a nerve stimulator. This time, we investigated whether narrow band imaging （NBI） could help surgeons to identify the nerve pathways on tumors, to determine incision sites on the epineurium, and to recognize tumor capsules on the epineurium.
As a result, NBI clearly delineated fibrous tissue, and so was effective in determining incision sites and in identifying tumor capsules on the epineurium. It was effective not only in schwannomas of the sympathetic nerve to which a nerve stimulator is not applicable, but also schwannomas to which a nerve stimulator is applicable. NBI appears to be helpful in detecting tumor capsules to determine a dissection margin for even less experienced surgeons and reducing the incidence of neurological deficits.