Mandibular Schwannoma: A Systematic Review of 33 Case Reports.

OBJECTIVE

This systematic review examines schwannomas of the mandibular nerve and its branches, focusing on clinical presentation, surgical management, and nerve preservation outcomes.

METHODS

A PRISMA-guided literature search was conducted on PubMed and Web of Science, including case reports and case series. Data extraction covered demographics, tumor location, symptoms, treatment, and nerve preservation for studies published between 2000 and 2024.

RESULTS

Forty-six English-published cases from 20 countries were analyzed, with China reporting the highest number (14). The female-to-male ratio was 1.36, with one unspecified gender. Age distribution showed a marked predilection for the fourth and fifth decades. The inferior alveolar nerve was the most affected (23 cases), followed by the lingual nerve (10 cases). Tumor sizes ranged from 0.5 to 12 cm. Swelling without pain (26 cases) was the most common symptom. Surgical approaches included enucleation, segmental resection, and en bloc resection. Nerve preservation was achieved in 34 cases, while 12 had nerve damage. Tumor location significantly affected nerve preservation (p = 0.000). Gender (p = 0.402) and clinical presentations (p = 0.291) were not significant factors.

CONCLUSION

Mandibular schwannomas present diagnostic and surgical challenges. The inferior alveolar nerve shows the highest preservation rate. Early diagnosis and meticulous surgical planning are essential for optimal functional outcomes.