Abstract
Background Hypoglossal schwannomas are rare intracranial neoplasms. Microsurgical resection
with the goal of cure is the aim of management but is associated with a high rate
of postoperative morbidity.
Objective The objective of the study was to outline the clinical presentation, radiologic characteristics,
surgical techniques, postoperative morbidity, and long-term follow-up results for
hypoglossal schwannomas.
Methods Patients treated for hypoglossal schwannoma at the Department of Neurosurgery of
a tertiary-level referral institution from January 2001 until December 2010 were analyzed
retrospectively using hospital records.
Results There were 14 patients who were treated in the study period. Tongue atrophy and swallowing
difficulties were the most common presenting symptoms. Surgery done in 12 patients
using a variety of approaches (retromastoid retrosigmoid suboccipital in 9, midline
suboccipital in 2, and far lateral in 1). Five patients having small residual tumors
received gamma knife (GK) subsequently. two patients received primary GK stereotactic
radiosurgery. Three patients had permanent morbidity in the form of cranial nerve
paresis. Immediate postoperative complications like cerebrospinal fluid leak and pneumonia
were present in three patients.
Conclusion Complete microsurgical resection is often associated with a high rate of morbidity.
Subtotal and near-total resection followed by stereotactic radiosurgery or observation
now offers an alternative approach.
Keywords
hypoglossal canal - schwannoma - skull base tumors - gamma knife - twelfth nerve
