gms | German Medical Science

Schwanomas are uncommon neurogenic tumors that are typically benign slow growing and asymptomatic. Up to 45% of all schwanomas originate in the head and neck region.

MRI is now considered the imaging study of the choice to evaluate the parapharyngeal space tumors.

Case Report: M.V. female, 43 years old, came in our hospital, with a giant neck mass in the left side. Tow years ago, she felt sore throat, and swelling in the left side of the throat. Flexible nasofaringolaryngoscopy revealed a giant tumor extending till the entrance of esophagus, but larynx was normal.

MRI was considered for diagnose. The tumor was well defined encapsulated and displacing the sheath vessels posteriorly, separating the carotid arteries from internal jugular vein. The schwanoma was an exceptionally large tumor (8*12*10 cm), arising from the vague nerve. Patient was prepared for any dysfunction of the involved nerve after the resection, but no neurologic dysfunction occurred.

Post-operative period was uneventful. No vocal cord paralysis, facial paralysis or hypoglossal paralysis was noted. Patient could not speak for 5 days, which we found vary rare. Patient suffered from lack of quality of voice, at least for 6 months. Preparatory the hot potatoes syndrome was present, after the surgery the fullness gone, but the voice was not like previous.

She took 10 séances of speech therapy, and regained the quality of her proper voice.

At Follow up after 6 months the patient was free of disease.

Conclusion: The surgical resection of big Schavanoma in the Parapharyngeal Space is the treatment of choice. MRI (cross-sectional imaging) can predict the likely nerve of origin, and allows us effective preoperative expectations, regarding the neurologic sequelae of surgical resection.

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