Sinonasal Schwannomas

Abstract

Objectives: Schwannomas of the nasal cavity and paranasal sinuses are uncommon. Treatment is surgical and endoscopic excision is a main indication. Our aim was to determine the incidence of rhinosinusal Schwannomas and the effectiveness of endonasal surgery with endoscopes to treat these tumors. Methods:The electronic medical records of all patients diagnosed with head and neck schwannomas were reviewed, excluding acoustic nerve neurilemomas and neurofibromas. Those who presented tumors located in the nose or paranasal sinuses were selected. They were treated with surgery in the Rhinosinusology section of ENT Department of the Hospital Italiano de Buenos Aires between March 1998 and December 2019.Results: Eighteen patients were selected who had histological (15/18) and clinical and imaging (3/18) diagnoses of neural type neoplasia, located in the head and neck.Two neck neurofibromas were excluded.Five patients with schwannomas located in the nasal cavity and paranasal sinuses were treated with surgery and had histopathological confirmation.The surgical technique varied according to the time of its indication.In four patients, an endonasal approach with endoscopes alone or combined with a frontal craniotomy was performed and in another a sublabial approach was made.The resection was complete in 4 patients and subtotal in another (intracranial extension with bilateral compromise of visual acuity). Conclusions:The incidence of sinonasal schwannomas within the nerve tumors diagnosed in the head and neck was 31.25% (5/16).Endoscopic excision was very safe and effective to treat the patients with sinonasal schwannomas.