[Schwannomas of the neck. About 3 cases, and literature review]

Schwannomas of the neck are rare. Their diagnosis remains difficult despite the evolution of imaging techniques. The goals of our study were to review the diagnostic and therapeutic approach for these tumors.

Retrospective study (1998-2005) concerning 3 cases of schwannoma in rare localizations: superior laryngeal nerve, ansa cervicalis and deep cervical plexus. These 3 patients were operated on in our ENT head and neck department. We made a review of the literature using the Medline database.

The mean delay between symptomatology and treatment was 5 years. In all cases, the schwannoma presented with a slowly-growing cervical mass. In only one case, the diagnosis of schwannoma was maded preoperatively. All 3 patients were treated surgically and the involved nerve was sacrificied. There were no postoperative complications. The mean follow-up duration was 3.5 years, with no recurrence.

To establish a diagnosis of neck schwannoma, ultrasound is the least sensitive imaging tool. Fine needle aspiration is especially useful to rule out other conditions. The most relevant diagnostic tools are CT-scan and especially MRI. Treatment is surgical; it should include sacrifice of the involved nerve. Surgical exploration of the neck and tumor resection could be performed at the same operation in the informed patient aware of the sequelae of nerve sacrifice, or otherwise be performed in two steps in the uninformed patient.