Nasal and paranasal sinus schwannomas

Computed tomography and pathological findings of five nasal neurilemmomas

“…Neurilemmomas can basically develop anywhere in the body, arising from the myelin sheaths of peripheral motor, sensory, sympathetic, and cranial nerves. The optic and olfactory cranial nerves are not potential sites of origin because they lack sheaths that contain Schwann cells [3]. The most common neurilemmoma in the head and neck is an acoustic neuroma arising from the eighth cranial nerve [4].…”

“…In general, Antoni A and collagen have been attributed to high density areas on CT. Antoni B, obsolete bleeding, and cystic changes have been attributed to areas of low density on CT. From this set of data and an analysis of the literature, we suggest that nasal cavity neurilemmomas have the following characteristics [3,18,19]:…”

“…Because they tend to grow slowly, radiological studies typically show expansive soft-tissue masses along with the preservation of most bony margins. This finding can be helpful in differentiating neurilemmomas from malignancies, as the latter tend to be aggressive and destroy bone [3], but intracranial extension has also been reported [19,22]. Enlargement of neurilemmomas can lead to areas of cystic degeneration as the tumors outgrow their blood supply.…”

“…The highest incidence of neurilemmoma is in the head and neck region (38–45%) [1,2], but involvement of the nose and paranasal sinus is quite rare, with only sporadic cases having been reported in the world literature. Fewer than 4% of these tumors involve the nasal cavity and paranasal sinuses [3]. …”

Role of endoscopic surgery in the management of sinonasal and skull base schwannomas

“…Nevertheless, angiography might be considered in selected cases of large tumors and to rule out JNAs in case of clinical and radiological suspicion. 13,35,36 From a surgical standpoint sinonasal schwannomas have been traditionally treated with external procedures. However, these approaches are burdened by a nonnegligible morbidity, including cosmetic problems, excessive scarring, and transient or permanent sensitive loss.…”