Mandibular swing approach for high parapharyngeal space schwannoma

Authors

  • Kumaran Ragavan Nerumathy ENT Speciality Hospital, Bodinayakanur, Tamil Nadu, India
  • Premnath Raja Department of Otolaryngology, Apollo Hospital, Madurai, Tamil Nadu, India
  • Balakrishnan Alagarsamy Department of Otolaryngology, Government Theni Medical College, Theni, Tamil Nadu, India
  • Amulya T. Manohar Department of Otorhinolaryngology, JJS Medical College, Mysore, Theni, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20233224

Keywords:

Parapharyngeal tumour, Vagal schwannoma, Transmandibular approach, Transparotid approach, Transcervical resection, Neck mass

Abstract

Parapharyngeal space tumours are rare, comprising 0.5% of all head and neck neoplasms. Different surgical approaches to this space have been described based on various criteria. Here, we are presenting a case report of a 65-year-old woman with left vagal schwannoma splaying the left internal carotid artery and internal jugular vein superiorly and splaying the left internal carotid artery and external carotid artery inferiorly, with its upper edge about 0.7 cm caudal to skull base. Surgery by a combined trans-cervical and mandibular swing approach was adopted for this case. The tumour which was extending so close to the skull base was removed in toto with an intact capsule and the neurovascular structures like the carotids, internal jugular vein and the vagus were preserved through a trans-mandibular approach. Postoperatively patient had no neurovascular compromise. Histopathological examination revealed vagal schwannoma. Trans-mandibular approach may appear complex, but it offers excellent surgical field to keep the delicate surrounding structures intact, to reduce the risk of haemorrhagic and avoid neurological complications.

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Published

2023-10-25

How to Cite

Ragavan, K., Raja, P., Alagarsamy, B., & Manohar, A. T. (2023). Mandibular swing approach for high parapharyngeal space schwannoma . International Journal of Otorhinolaryngology and Head and Neck Surgery, 9(11), 905–909. https://doi.org/10.18203/issn.2454-5929.ijohns20233224

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Section

Case Reports