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A novel technique to identify the nerve of origin in head and neck schwannomas

  • H H Ching (a1), A G Spinner (a1), N H Reeve (a1) and R C Wang (a1)
Abstract
Objective:

Identifying the nerve of origin in head and neck schwannomas is a diagnostic challenge. Surgical management leads to a risk of permanent deficit. Accurate identification of the nerve would improve operative planning and patient counselling.

Methods:

Three patients with head and neck schwannomas underwent a diagnostic procedure hypothesised to identify the nerve of origin. The masses were infiltrated with 1 per cent lidocaine solution, and the patients were observed for neurological deficits.

Results:

All three patients experienced temporary loss of nerve function after lidocaine injection. Facial nerve palsy, voice changes with documented unilateral same-side vocal fold paralysis, and numbness in the distribution of the maxillary nerve (V2), respectively, led to a likely identification of the nerve of origin.

Conclusion:

Injection of lidocaine into a schwannoma is a safe, in-office procedure that produces a temporary nerve deficit, which may enable accurate identification of the nerve of origin of a schwannoma. Identifying the nerve of origin enhances operative planning and patient counselling.

Copyright
Corresponding author
Author for correspondence: Dr Harry H Ching, Department of Otolaryngology – Head and Neck Surgery, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd, Suite 490, Las Vegas, NV 89102, USA Fax: +1 702 671 2245 E-mail: harry.ching@unlv.edu
Footnotes
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Presented at the American Academy of Otolaryngology – Head and Neck Surgery Annual Meeting, 18 September 2016, San Diego, California, USA.

Footnotes
References
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1Malone, JP, Lee, WJ, Levin, RJ. Clinical characteristics and treatment outcome for nonvestibular schwannomas of the head and neck. Am J Otolaryngol 2005;26:108–12.
2Green, JD, Olsen, KD, DeSanto, LW, Scheithauer, BW. Neoplasms of the vagus nerve. Laryngoscope 1988;98:648–54.
3Ijichi, K, Kawakita, D, Maseki, S, Beppu, S, Takano, G, Murakami, S. Functional nerve preservation in extracranial head and neck schwannoma surgery. JAMA Otolaryngol Head Neck Surg 2016;142:479–83.
4Yafit, D, Horowitz, G, Vital, I, Locketz, G, Fliss, DM. An algorithm for treating extracranial head and neck schwannomas. Eur Arch Otorhinolaryngol 2015;272:2035–8.
5Kim, SH, Kim, NH, Kim, KR, Lee, JH, Choi, HS. Schwannoma in head and neck: preoperative imaging study and intracapsular enucleation for functional nerve preservation. Yonsei Med J 2010;51:938–42.
6Furukawa, M, Furukawa, MK, Katoh, K, Tsukuda, M. Differentiation between schwannoma of the vagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis. Laryngoscope 1996;106:1548–52.
7Saito, D, Glastonbury, C. Parapharyngeal space schwannomas. Arch Otolaryngol Head Neck Surg 2007;133:662–7.
8Graffeo, CS, Van Abel, KM, Morris, JM, Carlson, ML, Van Gompel, JJ, Moore, EJ et al. Preoperative diagnosis of vagal and sympathetic cervical schwannomas based on radiographic findings. J Neurosurg 2016;126:18.
9Kitazume, Y, Ohashi, I, Katayama, T, Tsunoda, A, Kishimoto, S, Negi, M. Diffusion-weighted magnetic resonance neurography for parapharyngeal schwannomas: preoperative determination of the originating nerves. J Comput Assist Tomogr 2014;38:930–5.
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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