Yoichiro Sato1,2, Yorihisa Imanishi1,2, Toshiki Tomita1, Hiroyuki Ozawa1, Koji Sakamoto3, Ryoichi Fujii4, Seiji Shigetomi5, Noboru Habu6, Kuninori Otsuka7, Yoshihiro Watanabe8, Mariko Sekimizu1, Kaoru Ogawa1. 1. Department of Otorhinolaryngology - Head and Neck Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan. 2. Department of Otorhinolaryngology - Head and Neck Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, Japan. 3. Department of Otorhinolaryngology, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan. 4. Department of Otorhinolaryngology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Kanagawa, Japan. 5. Department of Otorhinolaryngology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan. 6. Department of Otorhinolaryngology, Kyosai Tachikawa Hospital, Tachikawa, Tokyo, Japan. 7. Department of Otorhinolaryngology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa, Japan. 8. Department of Otorhinolaryngology, Tokyo Saiseikai Central Hospital, Minato, Tokyo, Japan.
Abstract
BACKGROUND: Because the incidence of schwannoma arising from the parapharyngeal space (PPS) is very low, no studies have analyzed extirpation methods and postoperative neurological complications exclusively in PPS schwannomas. METHODS: The preoperative diagnosis and clinical outcomes of surgical treatment in 21 patients with PPS schwannoma who underwent surgery were investigated. RESULTS: Neurological deficit of the involved nerve developed in all patients regardless of the extirpation method used. However, the incidence of first bite syndrome in sympathetic chain schwannoma was significantly lower after intracapsular enucleation (40%) than after total resection (100%; P = .045). Furthermore, the incidence of postoperative complications unrelated to the involved nerve was lower after intracapsular enucleation (0%) than after total resection (42.9%; P = .055). CONCLUSION: Although postoperative neurological deficit of the involved nerve was unavoidable in PPS schwannoma, intracapsular enucleation could be beneficial by reducing its severity and the incidence of complications unrelated to the involved nerve.
BACKGROUND: Because the incidence of schwannoma arising from the parapharyngeal space (PPS) is very low, no studies have analyzed extirpation methods and postoperative neurological complications exclusively in PPS schwannomas. METHODS: The preoperative diagnosis and clinical outcomes of surgical treatment in 21 patients with PPS schwannoma who underwent surgery were investigated. RESULTS:Neurological deficit of the involved nerve developed in all patients regardless of the extirpation method used. However, the incidence of first bite syndrome in sympathetic chain schwannoma was significantly lower after intracapsular enucleation (40%) than after total resection (100%; P = .045). Furthermore, the incidence of postoperative complications unrelated to the involved nerve was lower after intracapsular enucleation (0%) than after total resection (42.9%; P = .055). CONCLUSION: Although postoperative neurological deficit of the involved nerve was unavoidable in PPS schwannoma, intracapsular enucleation could be beneficial by reducing its severity and the incidence of complications unrelated to the involved nerve.
Authors: Carlos Suárez; Fernando López; Juan P Rodrigo; William M Mendenhall; Remco de Bree; Antti A Mäkitie; Vincent Vander Poorten; Robert P Takes; Stefano Bondi; Luiz P Kowalski; Ashok R Shaha; Veronica Fernández-Alvarez; Julio C Gutiérrez; Nina Zidar; Carlos Chiesa-Estomba; Primoz Strojan; Alvaro Sanabria; Alessandra Rinaldo; Alfio Ferlito Journal: Adv Ther Date: 2022-06-11 Impact factor: 4.070