Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-03T00:00:39.031Z Has data issue: false hasContentIssue false
  • English
  • Français

Nerve-sparing subcapsular resection of head and neck schwannomas: technique evaluation and literature review

Published online by Cambridge University Press:  04 June 2013

A J Battoo ,
Z A Sheikh ,
K Thankappan ,
W Hicks Jr ,
S Iyer  and
M A Kuriakose
A J Battoo
Affiliation:
Department of Head and Neck Surgical Oncology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
Z A Sheikh
Affiliation:
Department of Surgical Oncology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
K Thankappan
Affiliation:
Department of Head and Neck Surgical Oncology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
W Hicks Jr
Affiliation:
Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA
S Iyer
Affiliation:
Department of Head and Neck Surgery and Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Cochin, Kerala, India
M A Kuriakose*
Affiliation:
Department of Head and Neck Oncology, Mazumdar Shaw Cancer Centre, Bommasandara, Bangalore, India
*
Address for correspondence: Dr M A Kuriakose, Department of Head and Neck Oncology, Mazumdar Shaw Cancer Centre, Bommasandara, Bangalore-560099, Karnataka, India Fax: 091-80-2832648 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The head and neck region harbours crucial structures and hence the surgical technique used to remove schwannomas from this region should cause minimal damage to these structures, with complete removal of pathology.

Methods:

This study entailed a retrospective analysis of 10 patients with head and neck schwannomas that were excised using a nerve-sparing subcapsular dissection technique. The primary aims were to assess the functional impact of the surgical technique on the structure of origin and to evaluate local control.

Results:

One patient with parapharyngeal schwannoma developed symptoms suggestive of ‘first bite syndrome’ in the late post-operative period. Another patient with facial nerve schwannoma had House–Brackmann grade II weakness in the immediate post-operative period, which subsequently resolved. None of the patients developed recurrence during a median follow-up period of two years.

Conclusion:

The nerve-sparing subcapsular dissection technique provided effective local control of tumour pathology, with relative preservation of neural function post-operatively.

Keywords

Head And Neck NeoplasmsSchwannomaSurgical Procedure, OperativeVagus NerveSympathetic Chain
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 7 , July 2013 , pp. 685 - 690
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Bradley, N, Bowerman, JE. Parapharyngeal neurilemmomas. Br J Oral Maxillofac Surg 1989;27:139–46CrossRefGoogle ScholarPubMed
2Colreavy, MP, Lacy, PD, Hughes, J, Bouchier-Hayes, D, Brennan, P, O'Dwyer, AJ et al. Head and neck schwannomas: a 10 year review. J Laryngol Otol 2000;114:119–24CrossRefGoogle Scholar
3Green, JD Jr, Olsen, KD, DeSanto, LW, Scheithauer, BW. Neoplasms of the vagus nerve. Laryngoscope 1988;98:648–54CrossRefGoogle ScholarPubMed
4Souza, JW, Williams, JT, Dalton, ML, Solis, MM. Schwannoma of the cervical sympathetic chain: it's not a carotid body tumour. Am Surg 2000;66:52–5CrossRefGoogle ScholarPubMed
5Moore, G, Yarington, CT Jr, Mangham, CA Jr.Vagal body tumours: diagnosis and treatment. Laryngoscope 1986;96:533–6CrossRefGoogle ScholarPubMed
6Valentino, J, Boggess, MA, Ellis, JL, Hester, TO, Jones, RO. Expected neurologic outcome for surgical treatment of cervical neurilemmomas. Laryngoscope 1998;108:1009–13CrossRefGoogle Scholar
7Kara, CO, Topuz, B. Horner's syndrome after excision of cervical sympathetic chain schwannoma. Otolaryngol Head Neck Surg 2002;127:127–8CrossRefGoogle ScholarPubMed
8Furukawa, M, Furukawa, MK, Katoh, K, Tsukuda, M. Differentiation between schwannoma of the vagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis. Laryngoscope 1996;106:1548–52CrossRefGoogle ScholarPubMed
9Saito, DM, Glastonbury, CM, El-Sayed, IH, Eisele, DW. Parapharyngeal space schwannoma: preoperative imaging determination of the nerve of origin. Arch Otolaryngol Head Neck Surg 2007;133:662–7CrossRefGoogle ScholarPubMed
10Zhang, H, Cai, C, Wang, S, Liu, H, Ye, Y, Chen, X. Extracranial head and neck schwannomas: a clinical analysis of 33 patients. Laryngoscope 2007;117:278–81CrossRefGoogle ScholarPubMed
11Leu, YS, Chang, KC. Extracranial head and neck schwannomas: a review of 8 years experience. Acta Otolaryngol 2002;122:435–7CrossRefGoogle ScholarPubMed
12Hood, RJ, Reibel, JF, Jensen, ME, Levine, PA. Schwannoma of the cervical sympathetic chain: the Virginia experience. Ann Otol Rhinol Laryngol 2000;109:48–51CrossRefGoogle ScholarPubMed
13Torossian, JM, Beziat, JL, Abou Chebel, N, Devouassoux-Shisheboran, M, Fischer, G. Extracranial schwannomas: a series of 15 patients. J Craniofac Surg 1999;10:389–94CrossRefGoogle ScholarPubMed
14Gilmer-Hill, HS, Kline, DG. Neurogenic tumours of the cervical vagus nerve: report of four cases and review of the literature. Neurosurgery 2000;46:1498–503CrossRefGoogle ScholarPubMed
15Donnelly, MJ, Al-Sader, MH, Blaney, AW. Benign nasal schwannoma. J Laryngol Otol 1992;106:1011–15CrossRefGoogle ScholarPubMed
16Stefansson, K, Woolmans, R, Jerkovic, M. S-100 protein in soft tissue tumours derived from Schwann cells and melanocytes. Am J Pathol 1982;106:261–8Google ScholarPubMed
17Russel, D, Rubinstein, L. Pathology of Tumours of the Nervous System. Baltimore: Williams and Wilkins, 1989Google Scholar
18de Araujo, CE, Ramos, DM, Moyses, RA, Durazzo, MD, Cernea, CR, Ferraz, AR. Neck nerve trunks schwannomas: clinical features and postoperative neurologic outcome. Laryngoscope 2008;118:1579–82CrossRefGoogle ScholarPubMed
19Zbaren, P, Markwalder, R. Schwannoma of the true vocal cord. Otolaryngol Head Neck Surg 1999;121:837–9CrossRefGoogle ScholarPubMed