title: [Huge skull base neurofibroma: case report].
abstract: A case of a huge skull base neurofibroma completely resected by a combined subtemporal-infratemporal and basal subfrontal approach is reported. A 32-year-old female complained of left facial paresthesia and deformity since several months before. Neurological examination revealed hypesthesia in the distribution of the left trigeminal nerve second branch. CT and MRI images showed a huge tumor in the infratemporal fossa, parapharyngeal space and middle fossa extending into the cavernous sinus, compressing the left temporal lobe and distorting the left hypothalamus and the brain stem. The patient tolerated trial balloon occlusion of the left internal carotid artery for 45 minutes. Transmaxillary biopsy revealed the tumor to be a neurofibroma. Through a combined basal subfrontal and a subtemporal-infratemporal approach in two staged operations, total tumor resection was performed. This tumor originated at the second branch of the trigeminal nerve. We recommend these combined approaches and two staged operations for such a huge skull base tumor as presented in this case.
authors.affiliation: Department of Neurosurgery, Seikeikai Hospital, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsuyama
authors.forename: T
authors.initials: T
authors.lastname: Shimomura
authors.forename: K
authors.initials: K
authors.lastname: Kawata
authors.forename: H
authors.initials: H
authors.lastname: Ohnishi
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009455:Neurofibroma / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014276:Trigeminal Nerve