A rare case of schwannoma of the mandibular nerve extending to parapharyngeal space managed with a preauricular trans mandibular approach

Abstract

Schwannoma also referred to as neurilemmoma or neurinomas arise from the Schwann cells of the autonomic nerves, peripheral nerves and cranial nerves except optic and olfactory nerves. Head and neck schwannomas account for 25 to 45% of schwannomas and the most common being vagal schwannomas and cervical sympathetic chain schwannomas. Schwannomas arising from the trigeminal nerve are rare and this case report consists of a schwannoma presenting as a left preauricular swelling involving the region of parotid extending from foramen ovale through the infratemporal fossa up to the parapharyngeal space. A combined preauricular trans mandibular approach enabled a complete excision of the tumor. Histopathological confirmation of a benign schwannoma was obtained and the patient is feeling well with minimal postoperative facial palsy with no trismus, occlusion abnormalities and no signs of recurrence on follow up.