Role of endoscopic surgery in the management of sinonasal and skull base schwannomas

Karligkiotis, Apostolos; Turri‐Zanoni, Mario; Sica, Eleonora; Facco, Carla; Freguia, Stefania; Mercuri, Anna Maria; Pistochini, Andrea; Bignami, Maurizio; Castelnuovo, Paolo

doi:10.1002/hed.24383

Cited by 10 publications

(8 citation statements)

References 45 publications

(141 reference statements)

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“…Karlikiotis et al 5 published a study with 11 cases of sino-nasal and skull base schwannomas. According to reported data, 2 patients had tumors in the PPF and 1 had a schwannoma with ITF involvement.…”

Section: Discussionmentioning

confidence: 99%

“…There are different treatment methods for TGSs, such as conservative treatments (wait and see), surgical interventions (open or minimally invasive surgeries), or radiosurgery (SRS). 1,[3][4][5][6] According to current management concepts, a TGS that was detected incidentally, without any symptoms, can be managed conservatively by performing serial radiological imaging to assess the growth rate. Basic indications for an intervention include an increased growth pattern in follow-up imaging or occurrence of symptoms (mostly neurological).…”

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confidence: 99%

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Purely Endonasal Endoscopic Approaches for Extracranial Trigeminal Nerve Schwannoma

Başak

Mülazımoğlu

Yücel

et al. 2022

Journal of Craniofacial Surgery

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The aim of this study is to assess the effectiveness and safety of purely endonasal endoscopic resection of extracranial trigeminal schwannomas (TGSs), with assessment of surgical and clinical outcomes in order to identify optimal candidates for an endonasal endoscopic approach (EEA). Methods: A retrospective review of patient's records operated for TGSs between 2008 and 2021 was conducted. Patients operated with a purely EEA were included in this study. Pictures from a frozen fresh cadaver head dissection were used to demonstrate the surgical approach and to show anatomic relationships, complexity of the surgical area and safe corridors for surgery.Results: A total of 5 patients (4 females and 1 male) were operated for TGS. All patients had facial numbness (100%) as a presenting symptom, followed by facial pain in 2 patients (40%), and orbital pain in 1 (20%). Also, 3 patients (60%) had a tumor originating at the level of the foramen ovale and 2 (40%) at the foramen rotundum. The mean tumor diameter was 3,7 ± 2 cm. Gross total resection were achieved in all cases. Postoperatively, 1 patient had severe mastication problems, 1 had blurred vision, and in the long-term follow-up, 1 had frontal sinusitis. The mean follow up was 106.6 (min:49, max:132, SD: 29.82) months. No recurrences were detected. Conclusions: In cases with the extradural TGS having limited extension into Posterior Cranial Fossa, or located in the Middle Cranial Fossa, a purely EEA is possible even for tumors bigger in size. Unilateral endonasal corridors are adequate for resection in most cases.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Purely Endonasal Endoscopic Approaches for Extracranial Trigeminal Nerve Schwannoma

Başak

Mülazımoğlu

Yücel

et al. 2022

Journal of Craniofacial Surgery

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“…Advances in endoscopic endonasal surgery, such as interventional radiology with preoperative embolization, improved instrumentation, computer-based navigation, and hemostatic materials, as well as a two-surgeon technique, have enabled endoscopic endonasal access to tumors of the PPF 6 . Primary tumors of the PPF, such as schwannomas of V2, are rare, while sinonasal tumors more frequently extend into the PPF 7 . Hence, relatively few studies (most of which were case series involving low numbers of patients) have investigated the endoscopic endonasal approach (EEA) to access tumors of the PPF 8 – 11 .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

Plzák¹,

Kratochvíl²,

Kešner³

et al. 2017

Clinics

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OBJECTIVES:Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa.METHOD:We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas) and one malignant tumor.RESULTS:No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma) that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome.CONCLUSION:The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.

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“…Frequently, open and endoscopic frontal sinus procedures are combined in order to achieve surgical success, maintaining the normal aeration/outflow of the frontal sinus 13 , 14 , 17 , 19 , 20 . In our case series, the combined procedure was the surgical strategy of choice in the majority of cases, in order to preserve the sinus ventilation.…”

Section: Discussionmentioning

confidence: 99%

The role of the osteoplastic flap in the endoscopic era: a retrospective multicentre experience on revision surgery

Pagella¹,

Maiorano²,

Turri‐Zanoni³

et al. 2023

Acta Otorhinolaryngol Ital

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SUMMARY Objective To retrospectively review the experience of five tertiary-care university hospitals on frontal sinus revision surgery with osteoplastic flap (OPF). Methods Descriptive analysis of patients who underwent frontal sinus surgery with OPF after one or more endoscopic procedures for benign and inflammatory pathologies from 2000 to 2022. Clinical charts were reviewed for demographics, indications, clinical presentation, previous frontal procedures, OPF technique and outcomes. Results Of the 124 patients who underwent an OPF procedure, 33 met inclusion criteria. With a mean of 2.1 previous endoscopic surgeries, Draf III was the most common former procedure. In 30 (91%) cases OPF was part of a combined procedure. The most common indications were inverted papilloma (61%), mucocele (9%) and chronic rhinosinusitis (6%). Frontal outflow stenosis (36%) and mucocele (9%) were the most frequent complications observed. Improvement of overall symptoms and patient satisfaction after the OPF procedure were recorded. Conclusions Even in the endoscopic era, OPF still represents a paramount procedure that should be included in the rhino-surgeon’s armamentarium, in particular in patients with challenging pathologies and anatomy when previous endoscopic endonasal attempts have failed.

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Role of endoscopic surgery in the management of sinonasal and skull base schwannomas

Abstract: The endoscopic endonasal approach is a valid alternative for the vast majority of sinonasal schwannomas with minimal morbidity for the patient. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2074-E2082, 2016.

Cited by 10 publications

References 45 publications

Purely Endonasal Endoscopic Approaches for Extracranial Trigeminal Nerve Schwannoma

Purely Endonasal Endoscopic Approaches for Extracranial Trigeminal Nerve Schwannoma

Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

The role of the osteoplastic flap in the endoscopic era: a retrospective multicentre experience on revision surgery

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