Middle cranial fossa trigeminal schwannoma resection through endoscopic transnasal maxillary sinus approach: A case report and literature review

Abstract

The endoscopic transnasal maxillary sinus approach is usually performed in resecting tumors located in the pterygopalatine fossa and infratemporal fossa, but is rarely used in the resection of lesions in the middle cranial fossa. Because of the complicated anatomical structure of the middle cranial fossa, trigeminal schwannomas (TSs) located in this region are usually dissected through conventional craniotomy surgical approaches; however, the endoscopic transnasal maxillary sinus approach can be used in resection of middle cranial fossa TSs. The current study presented the case of a 59-year-old man who suffered intermittent headaches for 2 years without other notable medical history and neurological abnormalities. The patient was diagnosed with a middle cranial fossa TS. After imaging and assessment of anatomical features, the tumor was totally resected through the transnasal maxillary sinus approach. Following surgery, the symptoms were relieved and the patient returned to a normal life. Light numbness was complained of in the distribution area of the maxillary nerve of the right side of the face, but this was gradually relieved. Combined with a literature review, the present case indicated that the endoscopic transnasal maxillary sinus approach may provide a safer and more direct option for resecting middle cranial fossa lesions, which is worthy of increased clinical application.