[Therapy of a schwannoma of the vagal nerve--stated at the example of an extensive tumor].

INTRODUCTION

Schwannoma of the vagal nerve are rare and usually accidentally found by exploring a slowly growing and painless neck tumor.

CASE: We report on a 49-year-old patient with an extensive schwannoma of the vagal nerve. The tumor grew from the brainstem to the lower neck vessel sheath and destroyed the skull base. The tumor had already involved all nerves of the foramen jugulare. The surgery was performed in cooperation with the neurosurgeons. Initially the cervical part of the tumor was removed by transcervical approach. Then the endocranial part of the tumor was removed by retrosigmoidal craniotomy and partial petrosectomy.

DISCUSSION: We have observed 5 schwannomas of the vagal nerve in 47,000 patients for 16 years. The diagnostic and therapeutic procedure is determined by the preoperative nerve function. In case of an intact nerve and after verifying the diagnosis of a schwannoma a detailed information given to the patient is absolutely necessary before any intervention. If the nerve lost its function there are no contraindications to resect the tumor and the nerve. Tumors with an intracranial extension should be treated interdisciplinarily (ENT/neurosurgery).