Surgical management of extracranial nerve sheath tumours in a tertiary care center

Abstract

Objective: Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structures. Methods: It is a retrospective study contained 13 consecutive patients of nerve sheath tumours involving the head and neck from March 2013 to February 2017 in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care referral hospital. The retrospective clinical data, diagnostic procedures, surgical approaches and their complications are analyzed after 12 months of surgery. Results: Total 13 patients, 7 were females and 6 were males. Painless neck swelling was the most common presentation found in 6 and the most common site of origin was the vagus nerve in the parapharyngeal space (6 patients). Transcervical excision of the tumour was performed in 7 patients. Six needed combined surgical approach for the excision of the tumours. Neurovascular injury was detected in 3 patients, and one patient had recurrent disease during the follow-up period. Conclusions: Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structure. Although the transcervical approach is commonly practiced for the majority of the tumours, combined approaches can be effectively applied for extensive nerve sheath tumours with the satisfactory clinical outcome. Keywords: Nerve sheath tumours, Surgical management, Outcome