Schwannomas of ear, nose, throat and neck

Abstract

Schwannoma is a benign tumour of nerve sheath origin with latent malignant potential. All cranial nerves can give rise to schwannoma except for olfactory and optic nerves, which are devoid of Schwann cell. Schwanommas are usually asymptomatic and present late owing to compression of nerve of origin. We present our study of 19 cases of schwannoma arising from unusual sites in head and neck, having varied presentation and the challenges faced in management of these cases. These cases presented in detail to the department of Ear, Nose and Throat, KEM Hospital, and were thoroughly evaluated clinically and radiologically to formulate a management strategy. Schwannoma of the head and neck is a rare entity but should be considered as differential diagnosis in unilateral nasal mass cases, palatal masses, anterior and lateral neck masses. Nerve of origin may not always be clear preoperatively but the possibility of postoperative loss of nerve function should be kept in mind. Radiological investigations like computed tomography scan and magnetic resonance imaging play a pivotal role in management. In case of nonvascular neck tumours, fine needle aspiration cytology is crucial but has low accuracy in the diagnosis of neural tumors. Histopathology of excised tumour remains the gold standard in diagnosis.