Complications of sympathetic chain schwannomatosis: a case report

Objective: to report a case of cervical sympathetic chain schwannomatosis. Study design: case report. Introduction: Schwannomas are benign tumors arising from the Schwann cells of the peripheral nerves. Its occurrence within the cervical sympathetic chain schwannomas is rare, and it merges within the parapharyngeal space usually as an asymptomatic and solitary mass. Case: a 42-years old female with a right parapharyngeal mass. An angio-magnetic resonance image revealed a tumor that slightly displaced of the internal carotid artery. Tumor excision was performed through a cervical approach. After surgery the patient developed a Horner’ syndrome and a First-bite syndrome, the second successfully treated with a botulinum toxin injection. Conclusion: sequelae derived from the excision of cervical sympathetic chain schwannomas include potential post-operative neural deficits as the Horner´s syndrome, and neuropathic pain as the first bite syndrome. We recommend the patient counseling about the potentials complications and sequelae of the intervention before the surgery is performed