Outcomes of Different Surgical Approaches in Tracheal Schwannoma: A Narrative Review

Introduction: Primary tracheal tumors are rare, with an estimated incidence of 1/million individuals. Tracheal schwannomas are exceptionally uncommon, and no consensus exists regarding optimal management. Reported treatment options include open surgical resection (OSR) and endoscopic (ES) approaches. Objective: To provide a narrative synthesis of reported cases of tracheal schwannoma, summarizing patient demographics, tumor characteristics, management strategies, outcomes, and recurrence. Materials and Methods: A narrative review was conducted through a comprehensive literature search across PubMed, Google Scholar, EMBASE, Scopus, Web of Knowledge, and Ovid. Data on baseline characteristics and outcomes were extracted from eligible studies. Findings were summarized descriptively using counts, percentages, means, and ranges. No inferential statistical analyses or meta-analytic synthesis were performed. Results: Forty-two studies reporting 48 patients were included. Twenty-seven patients underwent ES management, and 21 underwent OSR. Patients reported in the ES group were generally older, while sex distribution appeared broadly similar across the 2 treatment approaches. ES cases often involved smaller, intraluminal tumors, whereas open resection was more frequently applied to larger or extratracheal lesions. Across both approaches, over 90% of patients experienced symptom resolution, and recurrence was rarely reported. Follow-up durations varied widely, with many studies lacking long-term data. Conclusions: Both ES and OSR have been reported as effective treatment options for primary tracheal schwannoma. The choice of approach should be individualized based on tumor size, morphology, extension, and patient comorbidity. Given the narrative design and reliance on case reports and small series, these findings should be interpreted with caution, and further studies are needed to establish standardized management strategies.