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Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

Laith Mahmood¹, Nagi Demian, Yitzchak E Weinstock

¹Chief Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Texas Health Sciences Center, Houston, TX.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons

|July 30, 2013

Summary

A rare mandibular nerve schwannoma presented as two distinct tumors. A novel sagittal split ramus osteotomy approach successfully removed both lesions, avoiding extensive surgery and patient morbidity.

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Area of Science:

Oral and Maxillofacial Surgery
Neurosurgery
Oncology

Background:

Schwannomas are typically solitary tumors arising from Schwann cells of peripheral nerves.
Mandibular nerve schwannomas are rare, with unique presentations posing surgical challenges.
Standard surgical approaches often involve significant morbidity, such as hemimandibulectomy.

Observation:

A case of a mandibular nerve schwannoma presenting as two distinct tumors along the same nerve was observed.
One tumor was located within the body of the mandible, and the second was in the ipsilateral pterygomandibular space.
The patient presented with symptoms related to the dual nerve involvement.

Findings:

A unique surgical approach utilizing a sagittal split ramus osteotomy was employed for tumor removal.

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This technique provided adequate access to both distinct schwannoma portions.

The dual lesions were successfully excised, preserving nerve function and mandibular integrity.

Implications:

The sagittal split ramus osteotomy offers a less morbid alternative to traditional approaches for complex mandibular nerve schwannomas.
This case highlights the importance of tailored surgical strategies for rare tumor presentations.
Successful management of this unique mandibular schwannoma suggests potential for improved patient outcomes in similar cases.