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Mini-invasive surgery of infratemporal fossa schwannomas

Published online by Cambridge University Press:  08 January 2015

H Haidar
Affiliation:
Department of Otolaryngology and Skull Base Surgery, Nord University Hospital, Assistance Publique Hôpitaux de Marseille, France Department of Otolaryngology, Hamad Medical Corporation, Doha, Qatar
A Deveze
Affiliation:
Department of Otolaryngology and Skull Base Surgery, Nord University Hospital, Assistance Publique Hôpitaux de Marseille, France Laboratory of Applied Biomechanics, Faculty of Medicine of Marseille, Aix-Marseille University, France
J P Lavieille*
Affiliation:
Department of Otolaryngology and Skull Base Surgery, Nord University Hospital, Assistance Publique Hôpitaux de Marseille, France Laboratory of Applied Biomechanics, Faculty of Medicine of Marseille, Aix-Marseille University, France
*
Address for correspondence: Prof Jean Pierre Lavieille, Department of Otolaryngology and Skull Base Surgery, Nord University Hospital, Chemin des Bourrelly, 13915 Marseille, France E-mail: [email protected]

Abstract

Background:

Infratemporal fossa schwannomas are benign, encapsulated tumours of the trigeminal nerve limited to the infratemporal fossa. Because of the complications and significant morbidity associated with traditional surgical approaches to the infratemporal fossa, which include facial nerve dysfunction, hearing loss, dental malocclusion and cosmetic problems, less invasive alternatives have been sought.

Methods:

This paper reports two cases of infratemporal fossa schwannomas treated in 2012 using mini-invasive approaches. The literature regarding different infratemporal fossa approaches was reviewed.

Results:

The first schwannoma was 30 mm in size and was removed completely by a preauricular subtemporal approach. The second one was 25 mm in size and was removed completely using a purely transnasal endoscopic approach. In both cases, there were no intra-operative or post-operative complications.

Conclusion:

These two approaches allow non-invasive and wide exposure of the infratemporal fossa as compared to classical approaches. Surgical approach should be selected according to the tumour's anatomical location with respect to the maxillary sinus posterior wall. The preauricular subtemporal approach is recommended for tumours localised posterolaterally with respect to the maxillary sinus posterior wall. Medial and anterior tumours near the maxillary sinus posterior wall can be best removed using a transnasal endoscopic approach.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2015 

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