Benign Solitary Nerve Sheath Tumors: A Single Center Retrospective Case Series.

Abstract

Aim: To review the epidemiology, presentation, and outcomes of benign laryngeal nerve sheath tumors treated at our center.

Methods: We retrospectively analyzed the demographic data (age and sex), clinical profile, imaging, management, and follow-up of histopathologically confirmed benign solitary nerve sheath tumors of the larynx from January 2016 to August 2023.

Results: There were a total of 10 cases, 80% were schwannomas, and 20% were neurofibromas, all being sporadic with none associated with neurofibromatosis or schwannomatosis. There was no gender predilection. Schwannomas were predominantly found in the 6th to 7th decade of life, mostly located in the supraglottis, and presented with dysphonia. Neurofibromas were primarily glottic and found in the 7th decade of life. All tumors were excised by microlaryngoscopy; 80% with cold steel and 20% with transoral laser surgery. Postoperative vocal cord palsy was seen in three of the schwannomas excised, of which two recovered fully. There was one recurrence in each tumor type, which was managed by repeat transoral microlaryngeal surgery with no further recurrences. No vocal or swallowing dysfunctions were reported post-excision (VHI-10 and EAT-10 scores).

Conclusion: Peripheral nerve sheath tumors are rare but important differentials for mucosa-covered lesions of the larynx. Schwannomas are predominantly supraglottic, while neurofibromas may involve the glottis; both present with dysphonia as the primary symptom. Surgical excision, preferably transoral microlaryngoscopic resection, is the treatment of choice with good success and minimal complications.