Lower Cranial Nerve Schwannomas

Abstract

Lower cranial nerve (LCN) schwannomas are rare, benign
peripheral nerve sheath tumours arising from cranial
nerves IX–XII. Though uncommon, they pose significant
clinical challenges due to their complex anatomical
location and potential for neurological deficits. Jugular
foramen schwannomas (JFS) and hypoglossal
schwannomas (HS) are the most prevalent subtypes.
Clinical presentation varies by nerve involvement, ranging
from hoarseness and dysphagia to tongue atrophy and
paroxysmal cough. Diagnosis relies heavily on MRI and CT
imaging, with differentiation from paragangliomas being
critical. Classification systems guide surgical planning, with
gross total resection (GTR) being the goal, though subtotal
resection (STR) is preferred in cases with dense neural
adherence to preserve function. Gamma knife radiosurgery
(GKRS) offers an effective alternative for small or residual
lesions. Treatment must balance tumor control with
preservation of neurological function, requiring a
multidisciplinary and individualized approach.
Keywords: Schwannoma, Benign Neoplasms, Cranial nerve
neoplasms