Retrospectively Analyse The Therapeutic Effect Of Peripheral Neurilemoma

Objective To retrospective analysis the clinical characteristics, diagnosis and treatment of peripheral nerve sheath tumor. To discuss the risk factors for postoperative recovery of peripheral nerve sheath tumors(long-term follow-up after surgery if there is residual neurologic injury).Methods To retrospective analysis of the 96 cases of neurilemmoma admitted to our hospital from August 2010 to May 2014, which were confirmed by pathology and accept the surgical treatment. To statistical analysis the risk factors of postoperative recovery. gender, age, side,duration of symptoms, tenderness, Tinel sign, the number of affected nerve, the number of tumors and the volume of the tumor as 9 variables. First of all to univariate analysis of the risk factors of postoperative recovery using chi square test or nonparametric rank sum test or t test.The statistically significant variables in univariate analysis once again entered the multivariate logistic regression analysis. P < 0.05 has statistical significance.Results20 cases schwannomas were multiple in 96 cases, accounting for 20.8%, the most number up to 7 masses. 50 to 60 years old patients are most common. The most common nerves involved were tibial nerve and ulnar nerve, the second were the median nerve and brachial plexus, the least was found in the sciatic nerve. The male patients were slightly more than female patients, the number of tumors on left side slightly more than the right. 67 cases were followed up, the follow-up time ranged from 20 months to 56 months. Recurrence occurred in 2cases of the 67 cases, accounting for 3%.No Malignant transformation.50 cases without postoperative residual symptoms of nerve injury(no residual pain, sensory symptoms,neurological dysfunction) which accounted for 74.6%;17 cases have postoperative residual nerve injury symptoms, accounted for 25.4%; 8 cases appear relieved pain and sensory symptoms and motor weakness; 4 cases appear relieved pain but sensory symptoms still;1 case sensory symptoms relieved but pain still; 1 case feel relief of symptoms and pain, without motor improvement;pain, sensory symptoms were all not relieved in 1 case; 2 cases appear new motor weakness, decreased sensation after surgery.The statistically significant variables by Univariate analysis of the postoperative recovery are the duration of symptoms and the volume of tumors, The statistically significant variables by multivariate logistic regression analysis of postoperative recovery is the duration of symptoms.Conclusions Schwannoma most occurs range from 50 to 60 years old patients. The most common involved nerves are tibial nerve and ulnar nerve. Multiple peripheral nerve sheath tumors are common. The surgeon should notice the multiple ones during preoperative diagnosis and surgical resection. Ultrasonography is useful to early diagnosis of schwannoma, but the rate of exact diagnosis is slightly lower, and easily missed the diagnosis for the deeper and smaller ones. Preoperative use of MRI should be taken to Improve the diagnosis level.Postoperative nerve deficit related to the Surgical techniques and Microsurgical techniques is necessary. The postoperative recovery of schwannoma associated with the duration of symptoms and the volume of Peripheral Nerve Sheath Tumors, the duration of symptoms is the independent factor affecting the recovery of the peripheral nerve sheath tumor.