Hypoglossal schwannoma—successful reinnervation and functional recovery of the tongue following tumour removal and nerve grafting

Objective Hypoglossal nerve schwannomas are rare tumours that usually cause ipsilateral hypoglossal palsy. This report describes such lesions in two patients and suggests nerve grafting as part of the treatment regimen. Method Two patients with intra- and extra-dural hypoglossal schwannomas respectively were treated by direct surgery via a postero-lateral approach to the posterior fossa, hypoglossal canal and carotid sheath. Following tumour removal, sural nerve grafting was used to reconstruct the nerves. Unexpectedly, muscle bulk and motor function returned within 6 months in both patients. Conclusion Nerve grafting was highly successful in achieving functional recovery following surgery for hypoglossal nerve schwannomas.