Expected neurologic outcomes for surgical treatment of cervical neurilemomas.
OBJECTIVE
Neurilemomas are classically described as fusiform tumors that eccentrically displace the undisturbed neural fascicles. The authors seek to clarify the relationship of cervical neurilemomas to their nerve of origin and assess the functional outcome of surgical extirpation.


METHODS
A retrospective review of clinical, intraoperative, and histopathologic data of six patients with cervical extracranial neurilemomas.


METHODS
Additional histochemical staining of the pathologic specimens was performed to evaluate the tumor for neurites. A comprehensive literature review of cervical neurilemoma cases and meta-analysis of clinical outcomes in these cases were performed.


RESULTS
In the series of five consecutive cervical neurilemomas, only one was an eccentric mass pushing the undisturbed nerve aside. In the five other cases, excision of the neurilemoma required complete nerve excision. Neural elements traveling through the central portions of the tumor were clearly demonstrated histologically. Collective analysis of the literature on cervical neurilemomas revealed that although some cases allow nerve preservation, preservation of function is frequently poor.


CONCLUSIONS
This experience and that reported in the literature suggest that it is frequently impossible to preserve the function of the nerve of origin with surgical treatment of cervical neurilemomas.
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084, USA.
J
J
Valentino
M A
MA
Boggess
J L
JL
Ellis
T O
TO
Hester
R O
RO
Jones
D000293:Adolescent; D000328:Adult; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006651:Histocytochemistry; D006732:Horner Syndrome / Q000209:etiology*; D006801:Humans; D008297:Male; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology*