A rare lesion of the wanderer’s nerve with an unusual postoperative complication: vagal nerve schwanomma

Authors

  • Jagnnatha B. Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
  • Pandu Dasappa Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
  • Suhasini Hanumaiah Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
  • Arunima Sheeja Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20212908

Keywords:

Vagal nerve schwanomma, Cervical sympathetic chain, Horner’s syndrome

Abstract

Vagal nerve schwannomas are rare parapharyngeal tumours which was first described by Figi in 1933. Hoarseness is the most common symptom. Occasionally, a paroxysmal cough may be produced on palpating the mass. This is a clinical sign, unique to vagal schwannoma. Presence of this sign, along with a mass located on the medial border of the sternocleidomastoid muscle, should make clinicians suspicious of vagal nerve sheath tumours. However, in our case, the patient presented to us with a swelling in the neck and no other symptoms. MRI in the pre-operative work-up is helpful in defining diagnosis and in evaluating the extent and the relationship. A careful intracapsular enucleation with nerve-sparing technique remains the treatment of choice in order to avoid nerve injury which can lead to vocal cord paralysis. Horner’s syndrome following cervical surgeries is a rare phenomenon. Its occurrence following excision of a vagal schwannoma can occur due to direct injury to cervical sympathetic chain during excision or indirect injury due to traction on the sympathetic chain. Here is a case report of a patient diagnosed with left vagal scwanomma who developed horner’s syndrome post operatively.

Author Biographies

Jagnnatha B., Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India

Professor and HOD

Department of ENT

Pandu Dasappa, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India

Professor

Department of surgical oncology

Suhasini Hanumaiah, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India

Ssenior resident

Department of ENT

Arunima Sheeja, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India

Department ENT

FINAL YEAR PG STUDENT

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Published

2021-07-23

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Section

Case Reports