台耳醫誌

Schwannomas of the oropharyngeal region are rare benign nerve sheath tumors that may cause dysphagia, globus sensation, and choking episodes when they enlarge. We report a case of a 54-year-old woman with a six-month history of persistent globus sensation and intermittent choking. Clinical examination and flexible nasopharyngoscopy revealed a submucosal bulge over the left lateral oropharyngeal wall extending toward the hypopharynx. Computed tomography and magnetic resonance imaging demonstrated a well-defined mass in the lateral pharyngeal space adjacent to the internal carotid artery. Transoral robotic surgery was selected to improve visualization and enable precise dissection in a confined anatomical space. The tumor was removed successfully with combined robotic dissection and limited blunt dissection assisted by fingertip palpation near the carotid artery. Histopathological examination showed Antoni A and Antoni B areas with strong S-100 positivity, confirming schwannoma. The patient recovered uneventfully without dysphagia, aspiration, vocal palsy, or neurological deficit, and follow-up nasopharyngoscopy showed no residual or recurrent lesion. This case suggests that transoral robotic surgery can be a feasible minimally invasive option for selected lateral pharyngeal space schwannomas when careful preoperative imaging and intraoperative vascular awareness are applied. (J Taiwan Otolaryngol Head Neck Surg 2026; 60:128-133)