Hypoglossal Schwannomas: Single Institutional Experience of 14 Cases

Background: Hypoglossal schwannomas are very rare intracranial neoplasms. Microsurgical resection with the goal for 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, radiological 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 institute from January 2001 till 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. Twelve patients underwent definitive surgery and two were given primary gamma knife stereotactic radiosurgery. Five patients who had small residual tumors received GK subsequently. There was no mortality in the series. Three patients had permanent morbidity in the form of cranial nerve paresis. Immediate postoperative complications like infection, CSF leak, and pneumonia were present in four patients.

Conclusion: Hypoglossal schwannomas are rare tumors that are best treated by total surgical resection, with acceptable results of low rates of mortality and permanent morbidity. Subtotal resection is appropriate for tumors with adhesions to vital structures and in medically unfit patients. Small recurrences should be treated with GK therapy.