Abstract
Schwannomas are rare and slow growing tumours, arising from Schwann cells which provide myelin; less than 1 % of them degenerate into a malignant state. Although most studies are based on acoustic schwannomas, the majority of these tumours are non-vestibular and extracranial. Up to 45 % of them can be localised in head and neck districts, where they represent a diagnostic challenge because they are in differential diagnosis with lipoma, brachial cyst, paraganglioma and adenopathy. Between February 2002 and September 2012 our experience considers 18 patients affected by schwannomas localised in the neck in 14 cases, in the oral cavity in 2 cases, in the upper lip in 1 case and finally in the nose in 1 case. A painless neck mass was the major symptom referred, as well as dysphonia and oral pain. Ultrasound scan with fine needle aspiration biopsy was done in half of the group and was diagnostic in 30 %, whereas magnetic resonance imaging was diagnostic in 77 %, confirming its primary role in diagnostic work-up. The surgical approach was mainly by cervical incision and the intraneural extracapsular enucleation was the technique used without nerve injury in 89 % of cases. Follow-up period was 6–120 months and no evidence of relapse was registered.
References
Kanatas A, Mucke T, Houghton D, Mitchell DA (2009) Schwannomas of the head and neck. Oncol Rev 3:107–111. doi:10.1007/s12156-009-0015-6
Tarossian JM, Beziat JL, Abou Chebel N, Devouassoux-Shisheboran M, Fischer G (1999) Extracranial cephalic schwannomas: a series of 17 patients. J Craniofac Surg 10:389–394
Leu YS, Chang KC (2002) Extracranial head and neck schwannomas: a review of 8 years experiences. Acta Otolaryngol 122:435–437. doi:10.1080/00016480260000157
Kang G, Soo K, Lim D (2007) Extracranial non-vestibular head-and neck schwannomas: a ten-year experience. Ann Acad Med Singap 36:233–240
Liu HL, Yu SY, Li GK, Wei WI (2011) Extracranial head and neck schwannomas: a study of the nerve of origin. Eur Arch Otorhinolaryngol 268(9):1343–1347. doi:10.1007/s00405-011-1491-4
Malone JP, Lee WJ, Levin RJ (2005) Clinical characteristics and treatment outcome for nonvestibular schwannomas of the head and neck. Am J Otolaryngol 26:108–112. doi:10.1016/j.amjoto.2004.08.011
Russell SM (2007) Preserve the nerve: microsurgical resection of peripheral nerve sheath tumour. Neurosurgery 61:113–117. doi:10.1227/01.neu.0000289724.89588.bc
Furukawa M, Furukawa MK, Katoh K, Tsukuda M (1996) Differentiation between schwannoma of the vagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis. Laryngoscope 106:1548–1552. doi:10.1097/00005537-199612000-00021
Saito DM, Glastonbury CM, El-Sayed IH, Eisele DW (2007) Parapharyngeal space schwannomas: preoperative imaging determination of the nerve of origin. Arch Otolaryngol Head Neck Surg 133(7):662–667. doi:10.1001/archotol.133.7.662
Mikaelian DO, Holmes WF, Simonian SK (1981) Parapharyngeal schwannomas. Otolaryngol Head Neck Surg 89:77–81
Kim SH, Kim NH, Kim KR, Lee JH, Choi HS (2010) Schwannoma in head and neck: preoperative imaging study and intracapsular enucleation for functional nerve preservation. Yonsei Med J 51:938–942. doi:10.3349/ymj.2010.51.6.938
Sawada T, Sano M, Ogihara H, Omura T, Miura K, Nagano A (2006) The relationship between pre-operative symptoms, operative findings and postoperative complications in schwannomas. J Hand Surg Br 31:629–634. doi:10.1016/J.JHSB.2006.06.008
Park MJ, Seo KN, Kang HJ (2009) Neurological deficit after surgical enucleation of schwannomas of the upper limb. J Bone Joint Surg Br 91:1482–1486. doi:10.1302/0301-620X.91B11.22519
Donner TR, Voorhies RM, Kline DG (1994) Neural sheath tumors of major nerves. J Neurosurg 81:362–373. doi:10.3171/jns.1994.81.3.0362
Sakao T, Noguchi S, Murakami N, Uchino S (1990) Neurilemmoma of the neck. Nippon Geka Gakkai Zasshi 91:407–410
Colreavy MP, Lacy PD, Hughes J, Bouchier-Hayes D, Brennan P, O'Dwyer AJ (2000) Head and neck schwannomas: a 10 years review. J Laryngol Otol 114(2):119–124
Lahoti BK, Kaushal M, Garge S, Aggarwal G (2009) Extra vestibular schwannoma: a two year experience. Indian J Otolaryngol Head Neck Surg 63(4):305–309
Conflict of interest
We declare we have not received financial support in any form for the work we are submitting for publication.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bondi, S., Limardo, P., Toma, S. et al. Non-vestibular head and neck schwannomas: a 10-year experience. Eur Arch Otorhinolaryngol 270, 2365–2369 (2013). https://doi.org/10.1007/s00405-013-2520-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-013-2520-2