Objective: To report two cases of sinonasal schwannoma at our tertiary care institution and to review of the literature on the epidemiology, presenting symptoms, diagnosis, imaging, pathology, treatment and follow up.

Methods: Two patients with sinonasal schwannomas were retrospectively reviewed including their imaging, histopathology, and outcomes. In April of 2020, a comprehensive review of the existing literature on sinonasal schwannomas was conducted using PubMed. 

Results: Our study presents two male patients aged 49 and 80 years with symptoms of 16 and 4 years respectively. The first patient only had unilateral nasal congestion and mucopurulent discharge. The other patient had headaches, nasal obstructive breathing, intermittent left eye proptosis, pain and conjunctival injection. Imaging was supporting but non-diagnostic of sinonasal schwannoma.  Diagnosis was confirmed only by histopathology. Treatment consisted of transnasal endoscopic excision of mass with at least a 0.5 cm bony margin. Average follow up time was 1 week and there is no recurrence to date. The findings of our case series are consistent and representative of the literature review. 

Conclusion: We reported a case series and an updated review of the literature on sinonasal schwannomas. The differential diagnosis of a unilateral nasal mass should include sinonasal schwannomas. A high index of suspicion is required, and appropriate pre-operative imaging with Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of the sinus should be performed. Diagnosis is confirmed by histopathology. Complete surgical excision portends a better prognosis.

Sinonasal schwannoma case series and literature review

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