We present 4 cases of schwannomas arising from the cervical sympathetic chain. These lesions are uncommon and most often present as an asymptomatic solitary neck mass. Preoperative diagnosis can be difficult, even with the aid of computed tomography, magnetic resonance imaging, ultrasound, and angiography. While a paraganglioma can often be ruled out, exact determination of the nerve of origin is frequently elusive until the time of surgery. Operative excision remains the treatment of choice, often requiring sacrifice of a portion of the sympathetic chain. Postoperative Horner's syndrome is common, but does not appear to have an adverse effect on the patient.
ClairmontAAConleyJJ. Schwannoma of the cervical sympathetic nerve. Ear Nose Throat J1978; 57: 336–9.
2.
MyssiorekMDSilverCEValdesME. Schwannoma of the cervical sympathetic chain. J Laryngol Otol1988; 102: 962–5.
3.
TakimotoTKatohHUmedaR. Parapharyngeal schwannoma of the cervical sympathetic chain in a child. Int J Pediatr Otorhinolaryngol1989; 18: 53–8.
4.
Das GuptaTKBrasfieldRDStrongEWHadjuSI. Benign solitary schwannomas (neurilemomas). Cancer1969; 24: 355–66.
5.
ManigliaAJChandlerJRGoodwinWJParkerJCJr.Schwannomas of the parapharyngeal space and jugular foramen. Laryngoscope1979; 89: 1405–14.
6.
BailetJWAbemayorEAndrewsJCRowlandJPFuYSDawsonDE. Malignant nerve sheath tumors of the head and neck: a combined experience from two university hospitals. Laryngoscope1991; 101: 1044–9.
7.
GanesanSHararRPSOwenRADawkinsRSPriorAJ. Horner's syndrome: a rare presentation of cervical sympathetic chain schwannoma. J Laryngol Otol1997; 111: 493–5.
8.
SheridanMFYimDWS. Cervical sympathetic schwannoma: a case report and review of the English literature. Otolaryngol Head Neck Surg1997; 117(suppl): S206–S210.
9.
NagerGTHeroyJHoeplingerM. Meningiomas invading the temporal bone with extension to the neck. Am J Otolaryngol1983; 4: 297–324.
10.
McIlrathDCReMineWHDevineKDDockertyMB. Tumors of the parapharyngeal region. Surg Gynecol Obstet1963; 116: 88–94.
11.
GullanePJLampeHBSlingerR. Erosive parapharyngeal space teratoma. J Otolaryngol1986; 15: 317–21.
12.
SilverAJMawadMEHilalSKAscherlGFJrChynnKYBaredesS. Computed tomography of the carotid space and related cervical spaces (part II: neurogenic tumors). Radiology1984; 150: 729–35.
13.
LufkinRBHanafeeWN. MRI of the head and neck. New York, NY: Raven Press, 1991: 150–1, and 225.
14.
AbramowitzJDionJEJensenME. Angiographic diagnosis and management of head and neck schwannomas. AJNR Am J Neuroradiol1991; 12: 977–84.
15.
OlsenKD. Tumors and surgery of the parapharyngeal space. Laryngoscope1994; 104(Suppl 63).
16.
FurukawaMFurukawaMKKatohKTsukudaM. Differentiation between schwannoma of the vagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis. Laryngoscope1996; 106: 1548–52.
17.
MorrisJH. The nervous system. In: CotranRSKumarVRobbinsSL, eds. Robbins pathologic basis of disease. Philadelphia, Pa: WB Saunders, 1989: 1385–449.
18.
WenigBM. Atlas of head and neck pathology. Philadelphia, Pa: WB Saunders, 1993: 156.
