Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume -, Issue -, Pages -Publisher
WILEY
DOI: 10.1002/hed.27554
Keywords
avulsion; cerebrospinal fluid leakage; hypoglossal schwannoma; neck tumor; surgery
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This article presents an unexpected complication encountered during surgical excision of extracranial hypoglossal schwannoma, which is cerebrospinal fluid leakage. The importance of thorough preoperative evaluation and patient education is emphasized.
BackgroundExtracranial hypoglossal schwannoma is a rare tumor primarily treated with surgical excision. This article aims to highlight the potential for unexpected complications intraoperatively, such as cerebrospinal fluid leakage from skullbase to neck.MethodsA previously healthy 23-year-old male presented with tongue numbness. Magnetic resonance imaging revealed a 17 x 20 mm nodular lesion adjacent to the cervical segment of the internal carotid artery. Surgical excision was scheduled due to suspicion of a neurogenic tumor.ResultsIntraoperatively, despite careful handling, cerebrospinal fluid leakage was observed. Manipulation of the mass caused detachment of proximal nerve fibers, potentially indicating avulsion of the hypoglossal nerve from the brainstem or nearby. Clear fluid leakage from the skull base was also noted.ConclusionThorough preoperative evaluation and patient education regarding potential complications are crucial. This article presents an unexpected complication encountered during surgical excision of extracranial hypoglossal schwannoma, emphasizing the need for awareness and preparedness in such cases.
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