title: Superiority of resection over enucleation for schwannomas of the cervical vagus nerve: A retrospective cohort study of 22 consecutive patients.
abstract: BACKGROUND
  Schwannoma of the cervical vagus nerve is rare. Treatment options include intracapsular enucleation and en bloc resection. The purpose of this study was to compare the outcomes of enucleation and resection in terms of postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence, quality-adjusted life-year (QALY) and vocal handicap index (VHI).
  
  
  METHODS
  Twentytwo consecutive patients were divided into two groups. Patients in group A (n = 9) underwent intracapsular enucleation, whereas patients in Group B (n = 13) underwent en bloc resection. Main endpoints of the study were postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence and quality of life. The quality of life after surgery was assessed according to the quality-adjusted life-year (QALY) EQ-5D-5L methodology, and calculation of the voice handicap index (VHI).
  
  
  RESULTS
  Postoperative mortality was nil. Morbidity included 1 wound dehiscence in group A and 2 transitory dysphagias in group B. Freedom from vocal cord palsy was 22% in group A and zero in group B (p = 0.15). Operation-specific local recurrence rate was 33% (3/9 patients) in group A and nil in group B (0/23 patients) (p = 0.05). QALYs was 0.55 in group A and 0.54 in group B (p = 1.0). VHI was 23.77 in group A and 26.15 in group B (p = 1.00).
  
  
  CONCLUSIONS
  Resection is superior to enucleation in terms of freedom from local recurrence. Functional results are comparable for both techniques.
authors.affiliation: The "F. Durante" Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy. Electronic address: giulio.illuminati@uniroma1.it.
authors.forename: Giulio
authors.initials: G
authors.lastname: Illuminati
authors.affiliation: The "F. Durante" Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Pizzardi
authors.affiliation: The Department of Otolaryngology, The University of Rome "La Sapienza", Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Minni
authors.affiliation: The "F. Durante" Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Masci
authors.affiliation: The "F. Durante" Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Ciamberlano
authors.affiliation: The "F. Durante" Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Pasqua
authors.affiliation: The Division of Vascular Surgery, Sant'Anna Hospital, Catanzaro, Italy.
authors.forename: Francesco G
authors.initials: FG
authors.lastname: Calio
authors.affiliation: The "F. Durante" Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vietri
mesh_terms: D000328:Adult; D000368:Aged; D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009442:Neurilemmoma / Q000150:complications / Q000601:surgery*; D061646:Operative Time; D011184:Postoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000601:surgery*; D020421:Vagus Nerve Diseases / Q000150:complications / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000209:etiology
keywords: Schwannoma; Surgical treatment research registry 799; Vagus nerve