Extracranial cephalic schwannomas: A series of 15 patients

The aim of this study was to report a series of extracranial cephalic schwa nnomas. Fifteen patients with extracranial schwannomas treated between 1981 and 1999 are presented, and their clinical course during a median follow-u p of 4.1 years is discussed. There is a female predominance. No specific fa ctors have been identified. Their diagnosis is often delayed (median, 2.6 y ears). There is no predominant side. The orbit represents the most frequent location of schwannomas (26%). The trigeminal nerve is the most often affe cted (53%). Computed tomography and magnetic resonance imaging contribute t o the diagnosis. Macroscopically, the schwannoma is a well-defined tumor of ovoid form and brownish color. It is formed of soft tissues and is fragmen ted easily. Diagnosis is often evident on microscopic examination. The only treatment is surgery. It consists of enucleation after opening the epineur ium using an operating microscope, without interruption of the continuity o f the nerve. The authors have observed only two relapses (the first two pat ients operated without a microscope). Total excision allows recovery. Nerve injuries have variable prognosis. It is necessary in juvenile populations to search for neurofibromatosis. All schwannomas required surgical treatmen t using an operating microscope to obtain total recovery.