We report a rare case of schwannoma arising from the retropharyngeal space. A 24-year-old man presented a 2-month-history of a foreign body sensation in the throat and gradually progressing dysphagia when he swallowed solids and liquids. The patient had no odynophagia, fever, or blood in his saliva. Computed tomographic scans and magnetic resonance images revealed a well-defined and oval mass, measuring about 40 mm × 20 mm in size, in the retropharyngeal space. Because the tumor existed in the retropharyngeal space and was the adequate size, the patient underwent trans-oral resection under the direct laryngoscope without the need for skin incision. On the basis of the histological findings, the tumor was diagnosed as a schwannoma. It was mostly composed of spindle cells arranged in short bundles and fascicles, with focal palisading of the nuclei. The neoplasm arising from the retropharyngeal space is quite rare, because of few anatomical structures in the space. The post-operative course was uneventful, and the patient is currently free from disease 30 months after surgery. Diagnosis, clinical behavior, and treatment of retropharyngeal schwannoma are reviewed from perusal of the literature. When schwannomas are located in the pharynx, they may cause foreign body sensation or dysphagia. Therefore, when a foreign body sensation in the larynx is present, a thorough diagnostic procedure should be performed to evaluate the morphology of the upper aerodigestive tract. schwannoma; retropharyngeal space; trans-oral method

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Forty-four patients were hemodynamically stable. Nine patients (20%) were evaluated with CTA: 2 had vascular injuries, both requiring endovascular management, and 7 had negative studies. One patient with a negative CTA had a missed injury that required operative management. Thirty patients (68%) underwent a neck exploration: 18 had injuries treated with operative management and 12 had negative explorations. Five additional patients (11%) were observed without vascular studies and released. CONCLUSIONS: There is a significant rate of negative neck explorations in hemodynamically stable patients with zone II penetrating neck trauma. CTA may have a role as a screening tool in this subset of patients, and may avoid the morbidity associated with neck exploration. Prospective studies are needed to further delineate the role of CTA in this setting.

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