Function-preserving Surgical Management of Benign Peripheral Nerve Sheath Tumours: A Case Series

Peripheral Nerve Sheath Tumours (PNSTs) present a unique surgical challenge, requiring a balance between complete tumour removal and preservation of neurological function. Function-preserving excision techniques offer promising solutions, but their implementation demands careful evaluation and surgical expertise. A case series analysis was conducted on seven patients with PNSTs who underwent function-preserving surgical excision at a tertiary care centre between December 2022 and August 2024. Preoperative diagnostic methods, including high-resolution contrast-enhanced Magnetic Resonance Imaging (MRI) and Fine-Needle Aspiration Cytology (FNAC), were critical for differentiating schwannomas from neurofibromas and guiding surgical planning. Intracapsular enucleation was performed for schwannomas, while interfascicular dissection was used for neurofibromas. Patient demographics, tumour characteristics, surgical approach, and postoperative outcomes were assessed through clinical examination and neurophysiological studies. The series included five schwannomas and two neurofibromas, with a mean tumour size of 2.38 cm (range: 1.5-5.0 cm). Tumours were located in the upper extremity (n=3), the lower extremity (n=2), the neck (n=1), and the spinal region (n=1). Complete tumour resection was achieved in all cases. Transient postoperative deficits resolved within one month, and all patients returned to normal activities with no permanent neurological deficits at the six-month follow-up. Function-preserving surgical techniques demonstrate excellent outcomes in PNST management, achieving tumour control while maintaining neurological function. Careful patient selection, precise surgical technique, and appropriate preoperative planning are crucial for successful outcomes.