(A607) Presentation, Treatment, and Outcomes of Schwannomas of the Retropharyngeal Space (RPS): A Systematic Review

Introduction: The retropharyngeal space (RPS) is a potential space bounded anteriorly by the buccopharyngeal fascia and posteriorly by the prevertebral fascia. This review characterizes the typical presentation, surgical approaches, and outcomes for the rare cases of schwannomas occurring in the RPS.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted using Pubmed, Embase, and SCOPUS to identify case reports. Search terms included “schwannoma”, “neurinoma”, and “retropharyngeal”. Exclusion criteria included lack of clinical detail, being unavailable in English, or describing a schwannoma occurring in related but different anatomical spaces (i.e. parapharyngeal). 2 reviewers independently screened articles and extracted results.

Results: 13 cases of RPS schwannoma in the English literature were included for review. The most common presenting symptom was dysphagia (N=11), followed by a foreign body sensation (N=6) and voice change (N=3). Average age of presentation was 39 years and most patients were male (N=8). MRI was the most common imaging method (N=11); average reported size in MRI was 0.8 x 2.77 x 4.47 cm (AP by TR by CC). The most common method of excision was transoral (N=8) while some cases utilized a transcervical approach (N=5). Most patients reported no complications and had complete resolution of symptoms following treatment (N=12).

Conclusions: Our review suggests these tumors are typically amenable to transoral resection with a low risk of complications. Although very rare, retropharyngeal schwannoma should be considered in the differential diagnosis of patients presenting with progressive dysphagia, neck masses, or upper airway symptoms.