Parapharyngeal schwannomma: a case report

Abstract

Schwannomas are uncommon neurogenic tumors that are typically benign, slow growing, and asymptomatic. Upto 45% of schwannomas arise from the head and neck region, the sites of origin are: face, scalp, intracranial cavity, orbit, nasal and oral cavities, parapharyngeal space, middle ear, mastoid, larynx, and medial and lateral regions of the neck.  The age distribution is 30 to 70 years and male:female 3:1. Symptoms and signs are neck swelling (54%), pain (11%), cranial nerve palsy (10%), oropharyngeal swelling (8%), dysphagia (6%) and trismus, otalgia (11%). This case is being presented because it is the rare case of neck swelling.  A young male patient aged 22 yrs, presented with complains of swelling in right side of neck since 6 months. Patient also complains of difficulty in swallowing, difficulty in breathing and change in voice since 4 months. On examination of neck, a diffuse swelling noted at right level III neck, extending from the superior border of thyroid cartilage up to the level of hyoid bone.  Horizontally the swelling was extending from mid thyroid cartilage till the anterior border of sternocleidomastoid muscle. On examination of swelling, a pink smooth globular mass seen pushing the right aryepiglottic fold anteriorly obscuring the laryngeal inlet. No pooling of saliva. elective tracheostomy was done, through lateral cervical approach, mass was excised in toto and extubated after 7 days.