Head and neck schwannomas - a 10 year review

Schwannomas of the head and neck are uncommon tumours that arise from any p eripheral, cranial or autonomic nerve. Twenty-five to 45 per cent of extrac ranial schwannomas occur in the head and neck region and thus are usually i n the domain of the otolaryngologist. They usually present insidiously and thus are often diagnosed incorrectly or after lengthy delays, however, bett er imaging and cytological techniques have lessened this to some degree mor e recently. For benign lesions conservative surgical excision is the treatm ent of choice bearing in mind possible vagal or sympathetic chain injury. M alignant schwannomas are best treated with wide excision where possible. Th e role of adjuvant therapy remains uncertain and irrespective of treatment modality prognosis is poor with an overall survival of 15 per cent. However , recent advances in ms oncogene inhibitors may hold hope for the future.