Endoscopic resection of a chorda tympani schwannoma: A novel approach for an exceedingly rare entity

Abstract

We present a novel approach for a rare chorda tympani schwannoma. A case report as well as special considerations in all phases of care are reviewed. Laryngoscope, 2018.

A New Case of Endoscopic Resection of a Chorda Tympani Schwannoma

“…The conventional surgical method is the transmastoid operating microscope approach, although some surgeons use the transcanal endoscopic approach. There are 2 successful reported cases of endoscopic treatment of chorda tympani schwannoma via the external auditory canal, 1,5 and our case provides further evidence that this treatment is feasible. Chorda tympani schwannoma occurs in the tympanic cavity, and rarely enters the tympanic antrum.…”

“…Most cases show a mass obstructing the external auditory canal or behind an intact tympanic membrane. 1,3,[5][6][7]9 The clinical symptoms have no obvious specificity and are similar to other diseases, making chorda tympani schwannoma prone to misdiagnosis.…”

“…About 25% of schwannomas are reported to occur in areas of the head and neck, 2 but chorda tympani schwannomas are exceedingly rare, with only 12 reported cases in the English literature. 1,4,5 Only 2 cases of chorda tympani schwannoma have been clearly reported in the Chinese literature. 6,7 In this case report, we describe the clinical course of a patient presenting with a chorda tympani schwannoma treated with surgical resection using a transcanal endoscopic approach.…”

“…Common lesions in the middle ear include cholesteatoma, glomus tympanicum tumor, schwannoma of the nervous structures traversing the middle ear (facial, Jacobson, and Arnold nerves), middle ear adenomas, and rhabdomyosarcoma. 1 Schwannomas are benign tumors of schwann cells that do not normally invade adjacent soft tissue or bone, but cause symptoms and bone destruction locally. 2 Although the chorda tympani is a branch of the facial nerve, chorda tympani schwannoma is considered an independent subgroup of facial nerve schwannomas because of its clinical characteristics.…”

An Incidental Chorda Tympani Schwannoma Identified During Middle Ear Surgery

“…Schwannomas are the most common tumors of the facial nerve in the middle ear cleft. They can arise from any segment of the facial nerve or its branches ( 1 ).Although isolated chorda tympani schwannomas (CTS) are extremely rare, there are several reported cases in the English literature ( 2 , 3 , 4 ). The presented case is an incidental CTS identified during middle ear surgery for chronic otitis media.…”