title: Management of hypoglossal schwannomas: single institutional experience of 14 cases.
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.
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Ashish
authors: A
authors: Suri
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Sumit
authors: S
authors: Bansal
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Bhawani S
authors: BS
authors: Sharma
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Ashok Kumar
authors: AK
authors: Mahapatra
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Shashank Sharad
authors: SS
authors: Kale
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: P Sarat
authors: PS
authors: Chandra
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Manmohan
authors: M
authors: Singh
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Rajinder
authors: R
authors: Kumar
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Manish S
authors: MS
authors: Sharma
keywords: gamma knife; hypoglossal canal; schwannoma; skull base tumors; twelfth nerve