Superiority of resection over enucleation for schwannomas of the cervical vagus nerve: A retrospective cohort study of 22 consecutive patients.
INTRODUCTION
Schwannoma of the cervical vagus nerve is rare. Treatment options include intracapsular enucleation and en bloc resection. The purpose of this study was to compare the outcomes of enucleation and resection in terms of postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence, quality-adjusted life-year (QALY) and vocal handicap index (VHI).


METHODS
Twentytwo consecutive patients were divided into two groups. Patients in group A (n = 9) underwent intracapsular enucleation, whereas patients in Group B (n = 13) underwent en bloc resection. Main endpoints of the study were postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence and quality of life. The quality of life after surgery was assessed according to the quality-adjusted life-year (QALY) EQ-5D-5L methodology, and calculation of the voice handicap index (VHI).


RESULTS
Postoperative mortality was nil. Morbidity included 1 wound dehiscence in group A and 2 transitory dysphagias in group B. Freedom from vocal cord palsy was 22% in group A and zero in group B (p = 0.15). Operation-specific local recurrence rate was 33% (3/9 patients) in group A and nil in group B (0/23 patients) (p = 0.05). QALYs was 0.55 in group A and 0.54 in group B (p = 1.0). VHI was 23.77 in group A and 26.15 in group B (p = 1.00).


CONCLUSION
Resection is superior to enucleation in terms of freedom from local recurrence. Functional results are comparable for both techniques.
['Illuminati|Giulio|G|', 'Pizzardi|Giulia|G|', 'Minni|Antonio|A|', 'Masci|Federica|F|', 'Ciamberlano|Bernardo|B|', 'Pasqua|Rocco|R|', 'Calio|Francesco G|FG|', 'Vietri|Francesco|F|']
D000328:Adult D000368:Aged D003390:Cranial Nerve Neoplasms D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D037981:Neck Dissection D009364:Neoplasm Recurrence, Local D009442:Neurilemmoma D061646:Operative Time D011184:Postoperative Period D011788:Quality of Life D012189:Retrospective Studies D016896:Treatment Outcome D014630:Vagus Nerve D020421:Vagus Nerve Diseases D014826:Vocal Cord Paralysis
Schwannoma Vagus nerve Surgical treatment research registry 799