Hypoglossal schwannomas: A systematic review of the literature.

Cranial nerve 12 Hypoglossal schwannoma Neck swelling Peripheral schwannoma Skull base mass Twelfth nerve

Journal

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
ISSN: 1532-2653
Titre abrégé: J Clin Neurosci
Pays: Scotland
ID NLM: 9433352

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 13 10 2018
accepted: 12 11 2018
pubmed: 26 11 2018
medline: 9 5 2019
entrez: 26 11 2018
Statut: ppublish

Résumé

Schwannomas of the hypoglossal nerve are rare and account for a very small percentage of non-vestibular schwannomas. In this systematic review of the literature, we examined the epidemiology, symptomatology, management, and outcomes of patients with hypoglossal schwannomas. The electronic database Pubmed was searched for all reports of hypoglossal schwannomas with descriptions of symptoms, management, and outcome characteristics. Data was extracted from each study and compiled in a spreadsheet. Continuous variables were reported as means and medians. Categorical variables were reported as proportions. Additional analysis was not done due to inconsistent reporting of outcomes and small sample sizes. A total of 59 studies (94 total individual cases) were included. 64% of patients were female with mean age of 44.6 years. The majority were intracranial/extracranial (50%). The most common symptoms were tongue deviation or speech disturbance (38%) and headaches (33%). Hypoglossal nerve dysfunction was present in 80% of patients. Surgical excision was performed in 93%, with a 15% complication rate. Evidence of residual mass after surgery was noted in 29%. Permanent hypoglossal nerve deficits occurred in 67%. Recurrence of tumor burden was reported in 6 studies, with median time to recurrence of 16.5 months. Current evidence suggests overall favorable outcomes with surgical resection of hypoglossal schwannomas, with a large percentage of patients experiencing mild and usually well-tolerated neurologic deficit. Limitations of this study include the use of retrospective data taken from case reports/series with highly selected patients, selective reporting, and absence of control groups.

Sections du résumé

BACKGROUND BACKGROUND
Schwannomas of the hypoglossal nerve are rare and account for a very small percentage of non-vestibular schwannomas.
OBJECTIVES OBJECTIVE
In this systematic review of the literature, we examined the epidemiology, symptomatology, management, and outcomes of patients with hypoglossal schwannomas.
METHODS METHODS
The electronic database Pubmed was searched for all reports of hypoglossal schwannomas with descriptions of symptoms, management, and outcome characteristics. Data was extracted from each study and compiled in a spreadsheet. Continuous variables were reported as means and medians. Categorical variables were reported as proportions. Additional analysis was not done due to inconsistent reporting of outcomes and small sample sizes.
RESULTS RESULTS
A total of 59 studies (94 total individual cases) were included. 64% of patients were female with mean age of 44.6 years. The majority were intracranial/extracranial (50%). The most common symptoms were tongue deviation or speech disturbance (38%) and headaches (33%). Hypoglossal nerve dysfunction was present in 80% of patients. Surgical excision was performed in 93%, with a 15% complication rate. Evidence of residual mass after surgery was noted in 29%. Permanent hypoglossal nerve deficits occurred in 67%. Recurrence of tumor burden was reported in 6 studies, with median time to recurrence of 16.5 months.
CONCLUSION CONCLUSIONS
Current evidence suggests overall favorable outcomes with surgical resection of hypoglossal schwannomas, with a large percentage of patients experiencing mild and usually well-tolerated neurologic deficit. Limitations of this study include the use of retrospective data taken from case reports/series with highly selected patients, selective reporting, and absence of control groups.

Identifiants

pubmed: 30472335
pii: S0967-5868(18)31759-4
doi: 10.1016/j.jocn.2018.11.037
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

162-173

Informations de copyright

Copyright © 2018 Elsevier Ltd. All rights reserved.

Auteurs

Shivani Bindal (S)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States.

Tarek Y El Ahmadieh (TY)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States. Electronic address: tarek.elahmadieh@phhs.org.

Aaron Plitt (A)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States.

Salah G Aoun (SG)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States.

Om James Neeley (OJ)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States.

Najib E El Tecle (NE)

Department of Neurological Surgery, Saint Louis University Hospital, Saint Louis, MO, United States.

Samuel Barnett (S)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States.

Wayne Gluf (W)

Department of Neurological Surgery, The University of Texas Southwestern, Dallas, TX, United States.

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Classifications MeSH