Schwannomas of the head and neck region: A report of two cases with a narrative review of the literature

Schwannomas are slow-growing, encapsulated, benign tumors that can originate from any nerve covered with a sheath of Schwann cells. These tumors can originate from the cranial, peripheral, or autonomic nerves; about 25%–45% of schwannomas originate in the head-and-neck region, of which about 10% originate from either the vagal or sympathetic nervous system. They are rare tumors and are often asymptomatic, but depending on the location, they may produce secondary symptoms, such as swelling in the neck, dysphagia, and hoarseness of voice. The preoperative diagnosis of schwannomas is usually difficult because they often do not present with associated neurological deficits and can be misdiagnosed as other pathological conditions. Schwannomas should, therefore, be considered in the differential diagnosis of unilateral and slow-growing masses in the head and neck. The preferred modality for the treatment of schwannomas is surgical excision, and the recurrence of the tumor after complete resection is very rare. Vagal nerve injury is a common complication associated with surgical excision despite preserving nerve integrity. Therefore, the patients should be counseled preoperatively regarding the risk of developing neurological deficits. We searched in PubMed for articles related to schwannomas of the head and neck region, and extracted information regarding the symptoms, workup, management, and postoperative outcomes. We also discuss two cases, one with vagus nerve schwannoma and the other with supraclavicular cervical plexus schwannoma.