Parapharyngeal space schwannoma of hypoglossal nerve

Parapharyngeal schwannomas are rare benign neoplasms located in a difficult anatomical region. Most of them are asymptomatic and some presents late. Neurological deficit is a late finding, and it occurs only when the lesion is very large and compresses contiguous structures. Computed tomography (CT) guided fine needle aspiration cytology along with preoperative CT and magnetic resonance imaging can detect and diagnose it correctly and helps in proper planning and management. Total surgical excision is the treatment of choice. The approach is different as per the site, but trans-cervical approach is preferred. Recurrence is rare after complete excision. We are presenting a very rare parapharyngeal schwannoma arising from the hypoglossal nerve that was excised by trans-cervical approach without any complications and less morbidity as compared to other described approaches.