Extracranial non-vestibular schwannomas of the head and neck: a case series highlighting diverse anatomical locations and surgical approaches

Abstract Background Extracranial non-vestibular schwannomas of the head and neck are uncommon. The clinical features of these tumors can differ widely based on the nerve of origin and the size of the tumor. The primary objective of treatment is to achieve complete surgical removal. This study is highlighting the clinical, pathological characteristics as well as the individualized surgical approach for 10 cases of extra cranial non-vestibular schwannomas of the head and neck. Methods This series included 10 patients with extracranial non-vestibular head and neck schwannomas over 10 years. Complete surgical excision was performed for all patients. The proper surgical corridor was tailored for every individual patient, according to the site and the size of the lesion, by our head and neck team. Results Schwannoma locations included the neck ( n = 3) (submandibular, carotid space, parapharyngeal), sinonasal region ( n = 2), tongue base ( n = 1), retropharyngeal space ( n = 1), orbit ( n = 1), infratemporal fossa ( n = 1), and middle ear ( n = 1). Tailored surgical approaches were performed for every individual patient. Approaches included open approaches ( n = 4), endoscopic endonasal approaches ( n = 4), and transoral approaches ( n = 2). No major intraoperative or postoperative complications were reported apart from facial nerve paralysis and hypoglossal paralysis in the patients with facial nerve schwannoma and submandibular schwannoma respectively. No tumor recurrence was reported. Conclusion Extracranial non-vestibular schwannomas in the head and neck region represent a rare and diverse group of benign tumors, with their clinical presentations largely dependent on tumor size and location. Individualized surgical approaches and tailored treatment planning are critical to achieve optimum outcomes.