TY - JOUR
T1 - Functional outcome following intracapsular resection of head and neck peripheral nerve sheath tumors
T2 - a retrospective cohort
AU - Kampel, Liyona
AU - Serafimova, Marga
AU - Edalati, Shaun
AU - Brenner, Adi
AU - Masarwy, Razan
AU - Warshavsky, Anton
AU - Horowitz, Gilad
AU - Shapira, Yuval
AU - Muhanna, Nidal
N1 - Publisher Copyright:
© 2023, Canadian Society Of Otolaryngology-Head & Neck Surgery.
PY - 2023/12
Y1 - 2023/12
N2 - Background: Intracapsular resection of head and neck peripheral nerve sheath tumors (PNST) has emerged as a nerve-preserving technique compared to en bloc resection. The aim of this study was to evaluate and compare the functional outcome of both surgical techniques performed at a single tertiary referral center. Methods: This is a retrospective cohort of patients with head and neck PNST undergoing surgical resection from 2011 to 2021 at the Tel Aviv Sourasky Medical Center. Demographic data, the nerve of origin and surgical technique, including the use of intraoperative nerve monitoring were recorded and analyzed in association with postoperative functional outcomes. Results: Overall, 25 patients who had a cervical or parapharyngeal PNST resected were included. Nerve function was preserved in 11 of 18 patients (61%) who underwent intracapsular resection, while all those who underwent en bloc resections inevitably suffered from neurologic deficits (100%, N = 7). Sympathetic chain origin and an apparent neurologic deficit pre-operatively were associated with postoperative neural compromise. Conclusion: Improved functional outcome can be anticipated following intracapsular resection of extracranial head and neck PNST compared to complete resection, particularly in asymptomatic patients. Graphical abstract: [Figure not available: see fulltext.]
AB - Background: Intracapsular resection of head and neck peripheral nerve sheath tumors (PNST) has emerged as a nerve-preserving technique compared to en bloc resection. The aim of this study was to evaluate and compare the functional outcome of both surgical techniques performed at a single tertiary referral center. Methods: This is a retrospective cohort of patients with head and neck PNST undergoing surgical resection from 2011 to 2021 at the Tel Aviv Sourasky Medical Center. Demographic data, the nerve of origin and surgical technique, including the use of intraoperative nerve monitoring were recorded and analyzed in association with postoperative functional outcomes. Results: Overall, 25 patients who had a cervical or parapharyngeal PNST resected were included. Nerve function was preserved in 11 of 18 patients (61%) who underwent intracapsular resection, while all those who underwent en bloc resections inevitably suffered from neurologic deficits (100%, N = 7). Sympathetic chain origin and an apparent neurologic deficit pre-operatively were associated with postoperative neural compromise. Conclusion: Improved functional outcome can be anticipated following intracapsular resection of extracranial head and neck PNST compared to complete resection, particularly in asymptomatic patients. Graphical abstract: [Figure not available: see fulltext.]
KW - En bloc resection
KW - Intracapsular resection
KW - Intraoperative nerve monitoring
KW - Peripheral nerve sheath tumor
KW - Schwannoma
UR - http://www.scopus.com/inward/record.url?scp=85173000771&partnerID=8YFLogxK
U2 - 10.1186/s40463-023-00646-5
DO - 10.1186/s40463-023-00646-5
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C2 - 37789466
AN - SCOPUS:85173000771
SN - 1916-0208
VL - 52
JO - Journal of Otolaryngology - Head and Neck Surgery
JF - Journal of Otolaryngology - Head and Neck Surgery
IS - 1
M1 - 65
ER -