Retrospective study on extracranial neck schwannomas in tertiary care hospital in Nepal

Abstract

Introduction: Schwannomas are relatively rare tumors arising from Schwann cells that ensheath the peripheral nerves. The study aim was to identify extracranial neck schwannomas treated in a tertiary care hospital in Nepal.

Methods: We reviewed medical records of all patients with extracranial head and neck schwannomas treated at our department from July 2004 to June 2014.

Results: Ten such patients consisted of 7 males and 3 females were identified, with a mean age of 37.8 +/- 10.7 years (range: 20 to 54 years) with solitary schwannomas. Mean size of tumor was 5 cm (range: 2-10 cm). Most of the patients (60%) presented with asymptomatic palpable mass. Of these ten, 50% had a left sided neck mass. Seven originated from vagus nerve while three from sympathetic chain. The average duration of symptoms ranged from one month to two and half years. In all cases, tumor was completely resected through cervical approach. All tumors were enucleated keeping nerve of origin intact. In all cases, the tumor was completely resected surgically. The average follow up period ranged from one month to 108 months (median: 24 months). No major postoperative complications were noted. Two patients (20%) developed Homer's syndrome and one (10%) had temporary hypoglossal nerve palsy which recovered within three months.

Conclusion: Non-vestibular extracranial head and neck schwannomas most frequently present as an innocuous longstanding unilateral neck mass. The mainstay of treatment is complete excision preserving the nerve of origin. Early recognition of Schwannomas is key to optimal treatment.