Hypoglossal schwannomas: A systematic review of the literature

Shivani Bindal, Tarek Y. El Ahmadieh, Aaron Plitt, Salah G. Aoun, Om James Neeley, Najib E. El Tecle, Samuel L Barnett, Wayne M Gluf

Research output: Contribution to journalArticle

3 Scopus citations

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.

Original languageEnglish (US)
JournalJournal of Clinical Neuroscience
DOIs
StateAccepted/In press - Jan 1 2018

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Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Bindal, S., El Ahmadieh, T. Y., Plitt, A., Aoun, S. G., Neeley, O. J., El Tecle, N. E., Barnett, S. L., & Gluf, W. M. (Accepted/In press). Hypoglossal schwannomas: A systematic review of the literature. Journal of Clinical Neuroscience. https://doi.org/10.1016/j.jocn.2018.11.037