Clinical Features and Surgical Treatment of Schwannoma Affecting the Base of the Tongue: A Systematic Review.

Schwannomas of the head and neck account for 25-40% of all cases, with presentation at the base of the tongue as the most frequent site for intraoral tumors.  Here, a systematic review was conducted to include 15 cases of patients with schwannoma of the base of the tongue.  Most patients presented with a single, painless, well-encapsulated nodule at the base of the tongue. These nodules were slow-growing, with an average of 13.3 months from onset to presentation. Most cases were accompanied by airway obstruction, indicated by symptoms of dysphagia, dysarthria, snoring, and sleep apnea. Overall, the histological studies were consistent with a benign schwannoma with a palisading Antoni A and Antoni B pattern without malignant changes in cell morphology. These tumors were treated via complete surgical excision, and all cases achieved full remission by final follow-up.  Surgical removal is the primary mode of treatment with excellent postoperative prognosis and rare instances of recurrence. Given the rarity of this tumor, this review of available case studies serves to comprehensively describe clinical presentation and surgical treatment approaches to tongue base schwannoma.