Two Cases of Rare Schwannomas of the Vagal Nerve

Objective To present two rare cases of advanced large cervical schwannomas of the vagal nerve and analyze the factors which influence the possible surgical results.

Material and Methods During the 10-year period, at the Clinic of Neurosurgery of the Military Medical Academy, Sofia, we operated two patients with large cervical vagal nerve schwannomas using anterior cervical approach.

Results In both cases, we achieved gross total tumor removal. In one of the cases, we successfully preserved the fasciculus of the nerve. In the other case, we interrupted vagal nerve superior and inferior from the tumor to gross total resection. Despite the interruption of vagal nerve, there was no clinical presentation.

Conclusion There is no alternative treatment of the large cervical vagal nerve schwannomas to gross total resection of the tumor. Internal tumor decompression is needed when the tumor is larger than 3 cm, which helps for easier dissection of the tumor capsule and its respective fasciculi. While cutting the nerve and inability to recover it, occurrence of complications such as aphonia, respiratory, or swallow disturbance, depend on the place of swaying of the superior recurrent laryngeal nerve

Keywords vagal nerve schwannomas; surgery; outcome