Hypoglossal schwannomas: A systematic review of the literature

•Schwannomas of the hypoglossal nerve account for a very small percentage of non-vestibular schwannomas.•Current evidence suggests overall favorable outcomes with surgical resection of hypoglossal schwannomas.•A large percentage of patients (67%) experience mild and usually well-tolerated neurologic...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2019-04, Vol.62, p.162-173
Main Authors: Bindal, Shivani, El Ahmadieh, Tarek Y., Plitt, Aaron, Aoun, Salah G., Neeley, Om James, El Tecle, Najib E., Barnett, Samuel, Gluf, Wayne
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cranial nerve 12
Cranial Nerve Neoplasms
Female
Humans
Hypoglossal Nerve Diseases
Hypoglossal schwannoma
Male
Middle Aged
Neck swelling
Neurilemmoma
Peripheral schwannoma
Skull base mass
Twelfth nerve
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Summary:•Schwannomas of the hypoglossal nerve account for a very small percentage of non-vestibular schwannomas.•Current evidence suggests overall favorable outcomes with surgical resection of hypoglossal schwannomas.•A large percentage of patients (67%) experience mild and usually well-tolerated neurologic deficit. Schwannomas of the hypoglossal nerve are rare and account for a very small percentage of non-vestibular schwannomas. In this systematic review of the literature, we examined the epidemiology, symptomatology, management, and outcomes of patients with hypoglossal schwannomas. 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. 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. 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.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2018.11.037