Introduction:
Schwannomas are rare benign tumors originating from the perineural cells in the peripheral
nervous system (PNS). While well established therapeutic concepts exist for intracranial
schwannomas, there is a lack of consistent clinical standards for extracranial schwannomas.
Method:
This retrospective study describes the clinical pathway of 20 patients with histologically
proven extracranial schwannomas of the head and neck. The diagnostic and therapeutic
strategies for schwannomas are discussed with special emphasis on localization and
functional outcome.
Results:
Extracranial schwannomas of the head and neck region mostly originated from the facial
nerve (n = 4), vagal nerve (n = 4) or sympathetic chain (n = 3). Most common symptoms
were swelling (n = 12) and pain (n = 3). Preoperative imaging included MRI (n = 13),
ultrasound (n = 12) and CT (n = 3). Surgical intervention was performed in 18 cases
(n = 14 complete extirpation, n = 3 partial extirpation, n = 1 unknown). Regarding
completely extirpated schwannomas of motor nerves (n = 10) severing the nerve of origin
was more often required in patients with a preexisting functional deficit (3 out of
4 = 75 %) than in patients without preexisting deficits (2 out of 6 = 33 %).
Conclusion:
Representing rare tumors of the head and neck Region schwannomas require a systematic
diagnostic and therapeutic approach. Postoperative functional deficits after complete
extirpation must especially be anticipated in patients with a preexisting functional
deficit.
