A Case of Resection of a Vagal Nerve Schwannoma Under Continuous Intraoperative Neuromonitoring

Abstract

Schwannomas are rare benign tumors that arise from the neurolemmocytes. Among cases of schwannoma that arise from nerves, vagal nerve schwannoma is the most common in the head and neck region. Surgical resection is the treatment of choice. Postoperative complications such as hoarseness and dysphagia can affect the patients’ quality of life, so that attempts at nerve preservation should be made whenever possible.

A 46-year-old female patient underwent resection of a vagal schwannoma under continuous intraoperative neuromonitoring (CIONM) that allows real-time intraoperative feedback. The recurrent laryngeal and vagal nerve activities were monitored using an electromyographic endotracheal tube. We also used Narrow Band Imaging (NBI) to detect the tumor capsule and performed intracapsular excision of the tumor. She had no postoperative complications. In conjunction with NBI, CIONM allows for successful preservation of the vagal nerve and a reduced risk of postoperative complications.