Microdebrider decompression of schwannoma: a novel method of excising a neck mass.
OBJECTIVE
This case report describes the excision of a large neck neurofibroma causing compression of the esophagus and airway in a young patient with neurofibromatosis type 2 (NF2). At the conclusion of this article, readers should be able to describe a novel method of excising large encapsulated neck masses using microdebridement for decompression. The safety and efficacy of this method is discussed.


METHODS
The subject of this report was a 26-year-old woman with NF2. She presented with an enlarging right neck mass extending from the mandible to the clavicle that was compressing both her airway and esophagus. Given her auditory brainstem implant, unipolar cautery was contraindicated. Therefore, it was planned to decompress the patient's neck mass using a microdebrider before attempting to fully dissect out the mass.


METHODS
The neck mass was exposed and then entered. Using a Xomed XPS microdebrider (Medtronic Inc., Minneapolis, MN), the mass was debrided and debulked in all directions taking care not to violate the capsule. After this, the entire capsule was dissected out using only bipolar cautery and suture ligatures for hemostasis.


RESULTS
Microdebrider decompression of the neck neurofibroma allowed for preservation of the capsule without injuring vital structures in the neck. Postoperatively, the patient's swallowing and laryngeal function improved markedly.


CONCLUSIONS
Microdebrider debulking before dissection of the patient's large neck mass safely relieved compression of the airway and esophagus. This method may be applied to other large benign masses in the neck as well.
Chennupati
Sri Kiran
SK
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Schipor
Ioana
I
Mirza
Natasha
N
D000328:Adult; D003646:Debridement; D019299:Decompression, Surgical; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009464:Neuroma, Acoustic / Q000601:surgery*