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患者女、20岁,声音嘶哑八个月,间接喉镜检查左声带呈麻痹状态。x线胸片:左上纵隔主动脉弓水平气管左前部见一2.0×3.0cm大小肿块影,密度均匀,边缘光滑、整齐,未见钙化。胸部CT:主动脉弓旁可见一约1.67×1.35cm大小肿块影,外缘光滑,内缘与主动脉分界不清,CT值47Hu。B超:主动脉管腔及Dopper频谱正常,主动脉弓旁可见一1.5cm液性暗区,可测出静脉频谱,考虑为血管回声。1988年7月11日手术发现主动脉弓左侧偏前部有一2×3cm大小肿瘤,灰白色、质硬,起源于左迷走神经主干,肿瘤下极距喉返神经发出部外上2.0cm处。分离切除肿瘤后迷走神经主干已不完整,但仍留有神经被膜。病理诊断:神经纤维瘤。术后一年复查,声音嘶哑较术前减轻,间接喉镜检查左声带活动度差,仍呈麻痹状态。
The patient was 20 years old and had a hoarse voice for eight months. The indirect laryngoscopy showed a paralyzed left vocal cord. X-ray chest: Left upper mediastinal arch Aortic arch horizontal anterior left side of the trachea to see a size of 2.0 × 3.0cm lump size, uniform density, smooth edge, neat, no calcification. Chest CT: There is a 1.67×1.35 cm lump near the aortic arch. The outer edge is smooth, and the boundary between the inner edge and the aorta is unclear. The CT value is 47 Hu. B-ultrasound: The aortic lumen and Doppler spectrum are normal, and a 1.5 cm liquid dark area is visible next to the aortic arch. The venous spectrum can be measured and considered as a vascular echo. On July 11, 1988, a 2×3cm tumor was found in the left anterior part of the aortic arch. It was pale and hard and originated from the left vagus nerve trunk. The tumor was located 2.0 cm from the outer part of the recurrent laryngeal nerve. After excision of the tumor, the vagus nerve trunk has been incomplete, but it still has a nerve capsule. Pathological diagnosis: neurofibroma. One year after the review, hoarseness was reduced compared with before surgery. Indirect laryngoscopy showed poor vocal cord activity and remained paralyzed.