Saima Tabassum and Manish Gupta*
Department of ENT, Maharishi Markandeshwar Institute of Medical Sciences and Research, MMU, Mullana, Ambala, India
Received: 11 November, 2016; Accepted: 22 November, 2016; Published: 24 November, 2016
Dr. Manish Gupta, Department of ENT, MMIMSR, MMU, Ambala, India, Tel: 09915025819; E-mail:
Tabassum S, Gupta M (2016) Hypoglossal Nerve Schwannoma in the Submandibular Region: A Case Report and Discussion. Arch Otolaryngol Rhinol 2(1): 074-76. DOI: 10.17352/2455-1759.000029
© 2016 Tabassum S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Schwannoma; Hypoglossal nerve; Submandibular space; Benign tumorsSchwannoma; Hypoglossal nerve; Submandibular space; Benign tumors
Schwannomas of head and neck regioncommonly arise from the vestibular and vagus nerve. Hypoglossal nerve schwannomas are very rare. They may be intracranial only or have both intra and extracranial extension. Radiology specially, computed tomography (CT) and magnetic resonance (MRI) are useful in not only diagnosis but also identifying the nerve of origin. Total excision of the tumor via an external approach is the treatment of choice, for extracranial hypoglossal nerve schwannoma.
Schwannomas are solitary, encapsulated, benign tumors originating from Schwann cells, usually attached to or surrounded by a nerve of origin . Head and neck schwannomas account for 25% to 45% and often involve cranial nerve IV, V,VII,X,XI,XII or the sympathetic and peripheral nerves . About 10% of schwannomas in the neck region originate from vagus or sympathetic nervous system .
Schwannoma arising from hypoglossal nerve is very rare and may develop in intracranial part or may involve both the intracranial and the extracranial components assuming a dumb-bell shape . Peripheral i.e. extracranial hypoglossal schwannomas are extremely rare, and only few cases have been reported in literature till date .
Pre-operative computed tomography (CT) and magnetic resonance (MRI) are used to identify its origin. We present herein a rare case of hypoglossal nerve schwannoma presenting as right submandibular space mass.
A 45-year-old male presented with gradually progressive mass in the right submandibular region since 6 years. It was not associated with increased in size following food ingestion. There was no history of dental pain, difficulty or painful swallowing or discharge of purulent saliva from the floor of the mouth. Past, family and personal history were not contributory.
The local physical examination revealed a 4.5 x 5cm soft, non-tender, non-pulsatile, well-defined mass in the right submandibular region. Oral examination was normal.
Computed tomography imaging (CT) showed well-circumscribed oval mass in the right carotid space measuring 4.2cm x 3.2cm x 3cm anterior to carotid sheath vessels displacing and slightly compressing the right submandibular gland anteriorly (Figures 1,2). All the routine blood and urine investigations were normal.