Highlights
- •Schwannomas of the hypoglossal nerve account for a very small percentage of non-vestibular schwannomas.
- •Current evidence suggests overall favorable outcomes with surgical resection of hypoglossal schwannomas.
- •A large percentage of patients (67%) experience mild and usually well-tolerated neurologic deficit.
Abstract
Background
Schwannomas of the hypoglossal nerve are rare and account for a very small percentage
of non-vestibular schwannomas.
Objectives
In this systematic review of the literature, we examined the epidemiology, symptomatology,
management, and outcomes of patients with hypoglossal schwannomas.
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
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
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.
Keywords
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Article info
Publication history
Published online: November 21, 2018
Accepted:
November 12,
2018
Received:
October 13,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
