Cervical Sympathetic Chain Schwannoma: An Uncommon Cause of Horner's Syndrome

Villanueva-Alcojol, Laura; Monje, Florencio; González-García, R.; Ballester, David González; Arias, Jesús; Laza, Luı́s Ruı́z; Zaldı́var, Damián Manzano Sólo de; Gonzalez-Gonzalez, Fernando

doi:10.1016/j.joms.2011.04.008

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…Thereafter, the manual search results were cross‐referenced with the electronic search results, with this process yielding 1 additional article. A total of 51 articles representing 89 CSCS cases served as the final sample for our review 19‐69 …”

Section: Methodsmentioning

confidence: 99%

Diagnostic Approach, Treatment, and Outcomes of Cervical Sympathetic Chain Schwannomas: A Global Narrative Review

Navaie¹,

Sharghi²,

Cho-Reyes³

et al. 2014

Otolaryngol.--head neck surg.

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Section: Methodsmentioning

confidence: 99%

Diagnostic Approach, Treatment, and Outcomes of Cervical Sympathetic Chain Schwannomas: A Global Narrative Review

Navaie¹,

Sharghi²,

Cho-Reyes³

et al. 2014

Otolaryngol.--head neck surg.

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“…HS is characterized by the classic triad of miosis, partial ptosis, and hemifacial anhidrosis, because the release of norepinephrine from postganglionic oculo-sympathetic fibers, which innervate the muscle of Müller within the eyelid, the dilator of the iris, and the sweat glands of the face, is inhibited. 16 Although most authors reported postoperative HS to be very asymptomatic with no patient requiring intervention, 5,9 quality of life can be affected by distortion of the eyelid and pupils affecting facial aesthetics, visual impairment, and pain. 13 For a case that could not preserve CSC, miosis and ptosis were reported to occur on postoperative day 2, and additional clinical findings of HS, including enophthalmos, anhidrosis, and vasodilatation of the ipsilateral face would present during follow-up of 20 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…3 And a recent review has demonstrated that ICA and IJV splaying with medial ICA displacement carries a 75% probability of vagal nerve schwannoma; while the absence of such splaying with lateral ICA displacement carries an 87% probability of CSCS. 19 It is also worth noticing that CSCS could develop at the level of carotid bifurcation and cause splaying of the carotid bifurcation (the lyre sign), which should be differentiated from carotid body tumor, based on the vascularity of the mass, 12,16,20 and the observation that CSCS neither fills the crotch of the carotid bifurcation nor encases the arteries. 15 Yet, it is confusing that CSCS can show avid enhancement on MRI, 1 which might be associated with histological findings such as intra-tumoral hemorrhage and vasodilation, 12 and it could further be supported by our intraoperative findings of diffuse hemorrhage from inner surfaces of capsules, which indicated abundant blood supply to the schwannoma.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intracapsular Enucleation of Cervical Sympathetic Chain Schwannoma

Dong

et al. 2022

Ear Nose Throat J

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Objectives Schwannoma arising from cervical sympathetic chain (CSC) is a rare clinical entity. CSC is hard to preserve in CSC schwannoma (CSCS) surgeries, resulting in Horner’s syndrome (HS) and first bite syndrome (FBS). This article aims to explore our experience in successful preservation of CSC in CSCS surgeries. Methods This is a retrospective review of CSCS cases treated at our tertiary medical institution between Apr 2018 and March 2022. Only cases with successful intraoperative preservation of CSC were included. Results In total, 3 cases were included. There were 2 male patients and 1 female patient. Their age was between 38 years old and 66 years old (average and median age was 52 and 51 years old, respectively). Presenting symptom was neck mass for all them, 2 of which were on the left side, while 1 was on the right. Intracapsular enucleation of the CSCS was attempted and achieved in all 3 cases. Hemorrhage from the inner surface of capsules was diffuse and heavy. Constant saline irrigation, suction, and bipolar coagulation were needed to achieve hemostasis. Postoperative HS presented between 4 hours and 14 hours after surgery for all 3 patients, which took 1 month to 3 months to recover, whereas FBS did not occur in any patient. Median duration of follow-up was 6 months. No recurrence was observed. Conclusions Intracapsular enucleation should be attempted in CSCS surgeries, although hemorrhage might be diffuse and hard to control. When intracapsular enucleation was achieved, postoperative FBS can be avoided, while postoperative HS could occur, but its recovery was satisfactory.

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“…Since paralysis had already developed, the nerve was cut above and below the tumor, and the tumor was removed and histopathologically diagnosed as a schwannoma. Al-Mashat FM 5) 70 M 90 Anil 6) NA NA NA Ganesan 7) 77 M 30×40 Giustolisi 8) 65 F 34×18×17 Kahraman 9) 60 F 90×70×60 Kim 10) NA NA 20×30×60 Ozlugedik 11) 59 M 65×43 Politi 12) 46 F 70×50×50 Sheridan 13) 15 F 40×30 Villanueva-Alcojol 14) 57 F 39×28×25 Wax 15) NA NA NA 古川 16) 55 M NA…”

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confidence: 99%