SURGICAL COMPLICATIONS OF PARAPHARYNGEAL SCHWANNOMA: OUR EXPERIENCE

Abstract

Introduction– Tumors of parapharyngeal space are rare. Schwannomas, originating either from Schwann cells or fibroblasts supporting the nerve, are one of the benign neurological tumors occurring in this space. Surgical excision is the mainstay of its management. Transcervical approach is carried out for most of the parapharyngeal schwannomas. This article aims to study the clinical and radiological presentation of parapharyngeal schwannoma and also to study post-operative neurological outcome. Materials and methods – A retrospective study was conducted from June 2018 to November 2019 (1.5 years) at the Department of Otolaryngology, in a tertiary care medical college & hospital. A total of 7 cases of parapharyngeal schwannoma were selected; the clinical, radiological presentation was studied. Post-operative complications were studied within a follow up period of 8 months. Results – The mean age of presentation was 44 years. Male: Female ratio was 5:2. Five patients (71.4%) presented with left sided lesions whereas 2 patients (28.6%) were with right sided lesions. The most common presentation was an asymptomatic palpable neck mass in 4 patients (57.1%). 4 patients (57.1%) had mass arising from vagus nerve, 2 patients (28.6%) had mass arising from sympathetic trunk and one patient (14.3%) had mass arising from hypoglossal nerve. 4 patients (57.1%) had neurological complication in immediate post-operative period, out of which 3 patients (42.8%) improved within 8 months follow up. Conclusion – Most of the parapharyngeal schwannoma presents with asymptomatic slow growing neck and/or oropharyngeal mass. Progressive growth can result in dysphagia. Surgical excision may accompany neurological complications. Outcome of neurological sequelae depends on preserving the anatomical integrity of the nerve from which the tumor arises.