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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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References

1Krishnamurthy, S, Holmes, B, Powers, SK. Schwannomas limited to the infratemporal fossa: report of two cases. J Neurooncol 1998;36:269772Google Scholar
2Whitlock, RI, McCrea, RS, Emerson, TG. Neurilemmoma in the infratemporal fossa. Report of a case. Oral Surg Oral Med Oral Pathol 1967;24:2913003Google Scholar
3Arena, S, Hilal, EY. Neurilemmomas of the infratemporal space: report of a case and review of the literature. Arch Otolaryngol 1976;102:180–4Google Scholar
4Samii, M, Migliori, MM, Tatagiba, M, Babu, R. Surgical treatment of trigeminal schwannomas. J Neurosurg 1995;82:711–18Google Scholar
5Moffat, D, De, R, Hardy, D, Moumoulidis, I. Surgical management of trigeminal neuromas: a report of eight cases. J Laryngol Otol 2006;120:631–7Google Scholar
6Yamada, K, Ohta, T, Miyamoto, T. Bilateral trigeminal schwannomas associated with von Recklinghausen disease. AJNR Am J Neuroradiol 1992;13:299300Google Scholar
7Tiwari, R, Quak, J, Egeler, S, Smeele, L, Waal, IV, Valk, PV et al. Tumors of the infratemporal fossa. Skull Base Surg 2000;10:19Google Scholar
8Yoshida, K, Kawase, T. Trigeminal neurinomas extending into multiple fossae: surgical methods and review of the literature. J Neurosurg 1991;91:202–11Google Scholar
9Beauvillain, C, Calais, C, Launay, MC, Bordure, P, Zanaret, M, Legent, F. Nervous tumors of the infratemporal fossa [in French]. Ann Otolaryngol Chir Cervicofac 1991;108:107–11Google Scholar
10Ogren, FD, Wisecarver, JL, Lydiatt, DD, Linder, J. Ancient neurilemmoma of the infratemporal fossa: a case report. Head Neck 1991;13:243–6Google Scholar
11Tiwari, RM. Surgical landmarks of the infratemporal fossa. J Craniomaxillofac Surg 1998;26:84–6Google Scholar
12Rengahary, SS, McMahon, M, Bigongiari, LR, Ketcherside, J, Gunter, K. Neurofibroma of the infratemporal fossa: case report and technical note. Neurosurgery 1982;11:43–7Google Scholar
13Shinoara, Y, Uchida, A, Hiromatsu, T, Hida, K, Kikuta, T. A case of neurilemmoma in the infratemporal fossa showing the antral bowing sign. Dentomaxillofac Radiol 1993;22:214–15Google Scholar
14Sabit, I, Schaefer, SD, Coldwell, WT. Modified infratemporal fossa approach via lateral transantral maxillotomy: a microsurgical model. Surg Neurol 2002;58:2131Google Scholar
15Fisch, U. Infratemporal fossa approach to tumours of the temporal bone and base of the skull. J Laryngol Otol 1978;92:949–67Google Scholar
16Fisch, U, Fagan, P, Valvanis, A. The infratemporal fossa approach for the lateral skull base. Otolaryngol Clin North Am 1984;17:513–52Google Scholar
17Sekhar, LN, Schramm, VL Jr, Jones, NF. Subtemporal-preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. J Neurosurg 1987;67:488–99Google Scholar
18Al-Mefty, O, Anand, VK. Zygomatic approach to skull-base lesions. J Neurosurg 1990;73:668–73Google Scholar
19Kassam, AB, Gardner, P, Snyderman, C, Mintz, A, Carrau, R. Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurg Focus 2005; 19:E6Google Scholar