Objective: The aim is to share our experience of the clinical features and important issues encountered in diagnosing and treating multiple head and neck schwannoma cases seen at our centre, all of which went on to have surgical treatment. Methods: This was a retrospective review of the medical records of cases over an 11-year period (2007–2018) diagnosed with schwannoma by post-surgical histopathology. The demographic characteristics of these cases, along with their clinical characteristics, namely, tumour location, preoperative diagnostic tests undertaken, surgical approach used, and any postoperative complications, including the management of such complications, were reviewed. Results: A total of 31 patients (18 male, and 13 female) were included in the study. Contrast-enhanced magnetic resonance imaging was the most commonly used pre-operative diagnostic method (77%). 58% of the cases were extra- and 42% intra-cranial. Extracranial schwannomas were noted to arise from several different areas of the head and neck region. The most common neurological deficit post-operatively was facial paralysis. Conclusion: Since head and neck schwannomas can develop from any area where the nerve sheath is present, they may present with a wide variety of non-specific symptoms. The treatment plan should be made with the anticipated preoperative and postoperative neurological deficit firmly in mind.
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1. Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI. Benign solitary schwannomas (neurilemomas) Cancer 1969;24:355-66.
2. Zhang H, Cai C, Wang S, Liu H, Ye Y, Chen X. Extracranial head and neck schwannomas: a clinical analysis of 33 patients. Laryngoscope 2007;117:278-81.
3. Colreavy MP, Lacy PD, Hughes J, et al. Head and neck schwannomas--a 10 year review. J Laryngol Otol 2000;114:119-24.
4. Verocay J. Multiple Geschwulste als Systemerkrankung am nervosen Apparate. Dittrich P ed. In: Chiari H, editor. Festchrift Herrn Hofrat. Wien and Leipzig: W. Braumuller; 1908. p. 3421-52. [Book chapter in German]
5. Biswas D, Marnane CN, Mal R, Baldwin D. Extracranial head and neck schwannomas-a 10-year review. Auris Nasus Larynx 2007;34:353-9.
6. Çakır A, Erdağ TK, Ecevit MC, Güneri EA, Sütay S, İkiz AÖ. Extracranial head and neck schwannomas: A series of 14 patients. Kulak Burun Bogaz Ihtis Derg 2017;27:257-
7. Altuntaş EE, Bora A, Cerrah YSS, Müderris S, Elagöz Ş. Evaluation of the head and neck schwannoma’s in our clinic. [Article in Turkish] Cumhuriyet Tıp Derg 2012;34:289-94.
8. Leu YS, Chang KC. Extracranial head and neck schwannomas: a review of 8 years experience. Acta Otolaryngol 2002;122:435-7.
9. Hoeing B, Stuck BA, Kansy B, et al. Extracranial schwannomas of the Head and Neck: clinical approach based on 20 cases. [Article in German] Laryngo Rhino Otol 2017;96:607-14.
10. Yasumatsu R, Nakashima T, Miyazaki R, Segawa Y, Komune S. Diagnosis and management of extracranial head and neck schwannomas: a review of 27 cases. Int J Otolaryngol 2013;2013:973045.
11. Yafit D, Horowitz G, Vital I, Locketz G, Fliss DM. An algorithm for treating extracranial head and neck schwannomas. Eur Arch Otorhinolaryngol 2015;272:2035-8.