This study was conducted to examine the postoperative symptoms of patients with cervical sympathetic chain schwannoma, which are difficult to monitor during surgery, as well as the condition and postoperative symptoms of patients with these tumors who present with neurological deficits prior to surgery. The study population consisted of 20 patients who had undergone inter-capsular resection for cervical sympathetic chain schwannoma at our center between 2005 and 2020. We conducted a retrospective review of the age, sex, maximum tumor diameter, tumor position (upper neck type, middle neck type, lower neck type), preoperative neurological deficits, and postoperative neurological deficits in the patients.
Our results showed that 4 out of the 7 patients with upper- and lower-neck type tumors presented with preoperative neurological deficits, and that these patients were more likely, as compared to patients with middle-neck type tumors, to exhibit preoperative neurological deficits (p<0.01). Patients who presented with preoperative neurological deficits were unlikely to show improvement after the surgery, whereas the incidence of permanent paralysis after surgery was 25% in patients without preoperative neurological deficits. Therefore, we speculated that the risk of irreversible neurological deficits is higher in patients with tumors located in the upper or lower neck, which are the sites of compression of hard tissue.
