# Transoral Excision of an Intracordal Schwannoma: A Case Report and Review

## TL;DR

A new surgical method successfully removed a large vocal cord tumor through the mouth without neck surgery.

## Contribution

A combined endoscopic and microlaryngoscopic technique for transoral excision of bulky intracordal schwannomas is described.

## Key findings

- A 1.5 cm intracordal schwannoma was successfully removed transorally using combined endoscopic and microlaryngoscopic techniques.
- The tumor obstructed 40% of the laryngoscope's visual field but was fully excised without requiring a trans-cervical approach.
- The method allowed for effective visualization and removal of a bulky mass within the vocal cord soft tissue.

## Abstract

We discuss a novel approach to resecting a large 1.5 cm intracordal schwannoma via direct laryngoscopy with combined endoscopic and microlaryngoscopic techniques. Removing relatively bulky masses within the vocal cord soft tissue can be challenging secondary to difficult visualization of the operative field during direct laryngoscopy. We describe a case where a bulky atypical spindle cell schwannoma was removed via direct laryngoscopy via combined endoscopic and microlaryngoscopic techniques. The tumor obstructed 40% of the visual field of the laryngoscope. In this case, a 44-year-old female presented to the head and neck surgery clinic with 1.5 years of progressive hoarseness. On fiberoptic laryngoscopy, a mass was noted medializing the right true vocal cord. The patient was taken to surgery and after intubation and suspension with a Dedo laryngoscope, the mass was removed trans-orally through the laryngoscope with visualization using a combination of rigid and flexible endoscopy as well as with a microscope. Although visualization can sometimes be reduced using direct laryngoscopy, surgical excision of relatively large laryngeal masses can be performed in selected cases without the need to approach the masses trans-cervically.