The Diagnosis and Treatment of Laryngeal Schwannoma

Laryngeal schwannomas are rare benign tumors of the larynx. This study discusses the experience of the Second Xiangya Hospital in diagnosing and managing laryngeal schwannomas.

We retrospectively analyzed 14 cases of laryngeal schwannomas treated between 1997 and 2023. Patient age, sex, presenting symptoms, laryngoscopic findings, and imaging characteristics were revealed. All patients underwent surgical interventions via different approaches, including transoral endoscopic excision and external cervical approaches.

The cohort included 11 females and 3 males, with a mean age of 40.4 years (range, 22-65 years). The most common presenting symptoms were globus sensation, hoarseness, dysphagia, and dyspnea. The most frequently involved sites were the aryepiglottic fold, followed by the false cord and interarytenoid folds. Laryngoscopy typically revealed a round submucosal swelling, and computed tomography scans showed well-defined, oval-shaped lesions with mild heterogeneous enhancement. Ten patients underwent transoral endoscopic excision, and four underwent external cervical resection. All tumors were histopathologically confirmed as schwannomas and demonstrated positive S-100 immunostaining. One patient developed permanent hoarseness due to vocal cord injury during transoral endoscopic surgery. No cases of laryngeal stenosis were observed. In all but one case, surgical excision was curative with no recurrence during recorded follow up ranging from 3 to 172 months.

Laryngeal schwannomas are relatively rare. Complete surgical excision remains the most effective treatment. The optimal surgical approach should be guided by laryngoscopic and imaging findings.