Maxillary sinus schwannoma.

Schwannoma (neurilemmoma) is a benign tumour that arises from the Schwann cells which cover the nerve sheaths of the peripheral or autonomic nervous system especially the sympathetic system. Reported cases of schwannoma arising from the sinonasal tract are rare. We report a case of a 28-year-old man who presented to otolaryngology-head and neck surgery clinic with left cheek swelling and left-sided nasal obstruction for 1-year period. Endoscopic examination and high-resolution CT scan revealed a homogenous expansile mass occupying the left maxillary antrum extending to the left orbit and left ethmoidal air cells. The mass was excised through endoscopic endonasal approach followed by Caldwell-Luc approach for the residual tumour. Postoperative histopathological examination revealed benign type Antoni A schwannoma.

Vestibular Schwannoma Excision in Sporadic versus Neurofibromatosis Type 2 Populations.

OBJECTIVE: To understand the differences in characteristics of neurofibromatosis type 2 (NF2) and sporadic patients with surgically excised vestibular schwannomas in the state of California. STUDY DESIGN: Cross-sectional. SETTING, SUBJECTS, AND METHODS: The records of all patients who underwent vestibular schwannoma excision between 1997 and 2011 were extracted from the California Hospital Inpatient Discharge Databases (CHIDD). NF2 cases were identified using ICD-9-CM diagnosis code 237.72, neurofibromatosis, type 2. All other cases were recoded as sporadic. Trends in total number and population-adjusted rates (per 1 million California residents) of surgery, demographics, hospital case volume, state of residency, complications, length of stay, total charges, expected source of payment, and disposition were examined. RESULTS: Vestibular schwannoma (VS) excision was performed on 7017 patients, of which 464 patients (6.6%) had NF2. The population-adjusted surgery rate declined from 11.8 to 6.2 (P < .001) for sporadic cases and from 0.3 to 0.2 (P = .01) for NF2 cases over the study period. NF2 was associated with younger age (mean, 32.9 vs 51.3), higher rate of other complications (8.8% vs 4.4%) and facial nerve complications (32.3% vs 16.8%), higher total charges (median $70,106 vs $46,395), longer stay (median 5 vs 4), and high volume hospitals (80.4% vs 48.8%) (all P < .001). CONCLUSION: The surgery rates for vestibular schwannoma excision for both sporadic and NF2 patients have declined, but the decline is more prominent for sporadic cases. NF2 patients tend to be younger and have a longer hospitalization and possibly higher corresponding hospital charges compared to patients with sporadic VS.