| ORIGINAL ARTICLE |
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| Year : 2012 | Volume
: 14
| Issue : 1 | Page : 21-29 |
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Extra-Cranial head and neck schwannomas: The McGill experience
K Al-Qahtani1, S Anand2, M Black2, M Hier2, K Kost2, A Zeitouni2
1 Department of Otolaryngology-Head & Neck Surgery, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
2 The Department of Otolaryngology, McGill University, Montreal, Quebec, Canada
Correspondence Address:
MD, MSc, FRCSc K Al-Qahtani
Department of Otolaryngology-Head & Neck Surgery, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh
Saudi Arabia
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1319-8491.274766
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Extracranial schwannomas (ECS) of the head and neck are uncommon tumors of peripheral nerve sheath origin.
Methods: We reviewed our experience with ECS over the last 12 years with respect to presentation, management and outcome.
Results: Thirty-five cases of ECS at three centers were identified from 1992 to 2004 (16 women, 19 men). The mean age at diagnosis was 50.5 years (range 19 – 87 years). Sites of ECS distribution included 7 facial, 6 vagus, 5 sympathetic chain, 5 brachial plexus, 5 cervical plexus, 2 hypoglossal, 2 jugular foramen, 2 trigeminal, and 1 lingual nerve. The most predominant symptoms were a painful mass, and facial nerve or vocal cord paresis. Wide surgical excision was performed in 32 of 35 patients (91%). Median follow-up is 64 months. Post-operative sequelae included vocal cord paralysis, Horner’s syndrome, and facial nerve paralysis for which cable nerve grafting largely achieved partial re-animation. Recurrence occurred in 4 patients. Three were re-operated and one irradiated. They have remained tumour free since.
Conclusion: ECS are rare nerve sheath tumors often presenting in late stages at multiple sites in the head and neck. In our experience, surgical excision is the treatment of choice bearing in mind a potential for CN paralysis or sympathetic chain injury. Symptomatology of this tumour is discussed with its investigation and management.
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