Functional outcome following intracapsular resection of head and neck peripheral nerve sheath tumors: a retrospective cohort

Liyona Kampel, Marga Serafimova, Shaun Edalati, Adi Brenner, Razan Masarwy, Anton Warshavsky, Gilad Horowitz, Yuval Shapira, Nidal Muhanna*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.]

Original languageEnglish
Article number65
JournalJournal of Otolaryngology - Head and Neck Surgery
Volume52
Issue number1
DOIs
StatePublished - Dec 2023
Externally publishedYes

Keywords

  • En bloc resection
  • Intracapsular resection
  • Intraoperative nerve monitoring
  • Peripheral nerve sheath tumor
  • Schwannoma

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