Head and Neck Schwannoma Management: A Retrospective Study from South India

To evaluate the clinical presentations and management outcomes in patients with extracranial head and neck schwannomas (ECHNS). This retrospective single-centre study included 16 patients diagnosed with ECHNS from 2017 to 2023. A comprehensive evaluation of patient demographics, clinical presentations, and radiological findings, followed by a detailed assessment of treatment modalities, was done. For analytical purposes, cases were stratified into two categories: major and minor nerve schwannomas, enabling systematic evaluation of both immediate surgical outcomes and long-term nerve function status with rehabilitative measures. Patient mean age was 42 years, with a male-to-female ratio of 9:7. The predominant clinical presentation was a painless, slow-growing neck swelling (n = 9), with two patients exhibiting pre-existing neurological deficits. Surgical resection was undertaken in 15 of 16 cases. Among patients with major nerve schwannomas, postoperative nerve palsy occurred in 88% (8 patients). In contrast, patients who underwent resection of minor nerve schwannomas experienced immediate symptomatic improvement without postoperative complications. Despite rehabilitation and follow-up periods ranging from 1 month to 5 years, complete neurological recovery was not observed in any patient with major nerve involvement. Surgical resection of minor nerve schwannomas had favourable outcomes. In major nerve schwannomas, there is a significant risk of postoperative nerve dysfunction, and hence, a more conservative approach is recommended. Further studies to understand the natural history of these neoplasms and to optimise patient selection and timing of surgery are required.