Skip to main content Accessibility help

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

  • A J Battoo (a1), Z A Sheikh (a2), K Thankappan (a1), W Hicks (a3), S Iyer (a4) and M A Kuriakose (a5)...



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.


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.


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.


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


Corresponding author

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:


Hide All
1Bradley, N, Bowerman, JE. Parapharyngeal neurilemmomas. Br J Oral Maxillofac Surg 1989;27:139–46
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;114:119–24
3Green, JD Jr, Olsen, KD, DeSanto, LW, Scheithauer, BW. Neoplasms of the vagus nerve. Laryngoscope 1988;98:648–54
4Souza, JW, Williams, JT, Dalton, ML, Solis, MM. Schwannoma of the cervical sympathetic chain: it's not a carotid body tumour. Am Surg 2000;66:52–5
5Moore, G, Yarington, CT Jr, Mangham, CA Jr.Vagal body tumours: diagnosis and treatment. Laryngoscope 1986;96:533–6
6Valentino, J, Boggess, MA, Ellis, JL, Hester, TO, Jones, RO. Expected neurologic outcome for surgical treatment of cervical neurilemmomas. Laryngoscope 1998;108:1009–13
7Kara, CO, Topuz, B. Horner's syndrome after excision of cervical sympathetic chain schwannoma. Otolaryngol Head Neck Surg 2002;127:127–8
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;106:1548–52
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;133:662–7
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;117:278–81
11Leu, YS, Chang, KC. Extracranial head and neck schwannomas: a review of 8 years experience. Acta Otolaryngol 2002;122:435–7
12Hood, RJ, Reibel, JF, Jensen, ME, Levine, PA. Schwannoma of the cervical sympathetic chain: the Virginia experience. Ann Otol Rhinol Laryngol 2000;109:4851
13Torossian, JM, Beziat, JL, Abou Chebel, N, Devouassoux-Shisheboran, M, Fischer, G. Extracranial schwannomas: a series of 15 patients. J Craniofac Surg 1999;10:389–94
14Gilmer-Hill, HS, Kline, DG. Neurogenic tumours of the cervical vagus nerve: report of four cases and review of the literature. Neurosurgery 2000;46:1498–503
15Donnelly, MJ, Al-Sader, MH, Blaney, AW. Benign nasal schwannoma. J Laryngol Otol 1992;106:1011–15
16Stefansson, K, Woolmans, R, Jerkovic, M. S-100 protein in soft tissue tumours derived from Schwann cells and melanocytes. Am J Pathol 1982;106:261–8
17Russel, D, Rubinstein, L. Pathology of Tumours of the Nervous System. Baltimore: Williams and Wilkins, 1989
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;118:1579–82
19Zbaren, P, Markwalder, R. Schwannoma of the true vocal cord. Otolaryngol Head Neck Surg 1999;121:837–9



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed