Browse > Article

Clinical Comparison of Surgical Treatment and Close Observation Without Surgery in the Management of Schwannomas in the Neck  

Hong, Sung-Lyong (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
Jung, Young-Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Hospital)
An, Soo-Youn (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
Hah, J.-Hun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
Sung, Myung-Whun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
Kim, Kwang-Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
Publication Information
Korean Journal of Head & Neck Oncology / v.25, no.1, 2009 , pp. 24-27 More about this Journal
Abstract
Backgrounds and Objectives : Most patients with neck schwannomas are asymptomatic. Surgical management of neck schwannomas could cause various complications. The aim of this study is to evaluate the necessity of surgical management in all of the neck schwannoma patients. Material and Methods : Thirty-four patients diagnosed and undergone surgical management as neck schwannomas and 30 patients diagnosed and observed closely by OPD base from 1996 to 2005 were included. The medical records were reviewed retrospectively. Results : In surgical management group, mean age was 39.3 years and mean size of tumors was 4.4cm. Twenty-five patients had their tumors at parapharyngeal space, 2 at anterior neck and 7 at lateral neck. Nerves of origin were vagus nerve in 12 patients, cervical sympathetic chain in 11. Presenting symptoms were neck mass in 22 patients and no symptom in 9. On the other hand, in close observation group, mean age was 47.1 years and mean size of tumor was 3.7cm. Seventeen patients had their tumors at parapharyngeal space, 5 at anterior neck and 8 at lateral neck. Presenting symptoms were neck mass in 13 patients and no symptom in 13. There were no patients with neurologic complications. Mean follow-up duration was 38.2 months and there were only 2 patients whose size of tumors was increased and no patients who had newly emerged symptoms. Conclusion : Neck schwannomas grows slowly, has little chance of malignant transformation, but can complicate serious problems after surgical management. Therefore close observation could be considered in many asymptomatic patients.
Keywords
Schwannoma; Surgery; Observation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Wax MK, Shiley SG, Robinson JL, Weissman JL. Cervical sympathetic chain schwannoma. Laryngoscope. 2004;114:2210-2213   DOI   ScienceOn
2 Hamza A, Fagan JJ, Weissman JL, Myers EN. Neurilemmomas of the parapharyngeal space. Arch Otolaryngol Head Neck Surg.1997;123:622-626   DOI   PUBMED   ScienceOn
3 al-Otieschan AA, Saleem M, Manohar MB, Larson S, Atallah A. Malignant schwannoma of the parapharyngeal space. J Laryngol Otol. 1998;112:883-887   DOI   PUBMED   ScienceOn
4 Moukarbel RV, Sabri AN. Current management of head and neck schwannomas. Curr Opin Otolaryngol Head Neck Surg. 2005;13:117-122   DOI   ScienceOn
5 Ducatman BS, Scheithauer BW, Piepgras DG, Reiman HM, Ilstrup DM. Malignant peripheral nerve sheath tumors: A clinicopathologic study of 120 cases. Cancer. 1986;57:2006-2021   DOI   ScienceOn
6 Greager JA, Reichard KW, Campana JP, DasGupta TK. Malignant schwannoma of the head and neck. Am J Surg. 1992;163:440-442   DOI   ScienceOn
7 Wilson JA, McLaren K, McIntyre MA, von Haacke NP, Maran AGD. Nerve-sheath tumors of the head and neck. Ear Nose Throat J. 1988;67:103-110   PUBMED
8 Toriumi KM, Atiyah RA, Murad T. Extracranial neurogenic tumors of the head and neck. Otolaryngol Clin Nor Am. 1986;19:609-617