The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
Enucleation of vagal nerve schwannoma using intraoperative nerve monitoring†
Article first published online: 2 FEB 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 4, pages 790–792, April 2012
How to Cite
Gibber, M. J., Zevallos, J. P. and Urken, M. L. (2012), Enucleation of vagal nerve schwannoma using intraoperative nerve monitoring. The Laryngoscope, 122: 790–792. doi: 10.1002/lary.22485
- Issue published online: 20 MAR 2012
- Article first published online: 2 FEB 2012
- Accepted manuscript online: 26 NOV 2011 12:06AM EST
- Manuscript Accepted: 13 OCT 2011
- Manuscript Revised: 1 OCT 2011
- Manuscript Received: 29 JUN 2011
Vagal nerve schwannomas are rare, benign, neural sheath tumors. The treatment of enlarging or symptomatic vagal nerve schwannomas is surgical resection. Transecting the vagus nerve results in significant morbidity, and attempts at nerve preservation should be made whenever possible. We introduce a nerve-sparing technique using meticulous microsurgical dissection and intraoperative nerve monitoring for vagal schwannomas. A 61-year old patient presented with an enlarging 2-cm right vagal nerve schwannoma. She underwent resection via a transcervical approach. The patient was intubated with an electromyographic (EMG) endotracheal tube that allowed for monitoring of the recurrent laryngeal nerve intraoperatively. A microsurgical subcapsular dissection was performed after branches of the vagus nerve were identified using a nerve probe and preserved. At the conclusion of the resection the nerve was intact and stimulated along its entire course. Postoperatively, the patient had normal vagal nerve function. We introduced the role of intraoperative nerve monitoring using an EMG endotracheal tube for successful enucleation of vagal schwannomas. In conjunction with meticulous microsurgical dissection, nerve monitoring allows for successful preservation of the vagus nerve and decreased postoperative morbidity. Laryngoscope, 2012