Nasal-subfrontal giant schwannoma.
Subfrontal schwannomas are rare lesions. They can be misdiagnosed as olfactory meningiomas or neuroblastomas. We report a case of giant schwannoma involving the anterior cranial fossa; the frontal and ethmoid sinuses and nasal cavities. The patient presented with a year-long history of increasingly severe headache associated with insomnia. Examination revealed no neurological deficit except for the anosmia. Magnetic Resonance Imaging revealed a 9x5x3 cm intranasal-subfrontal extraaxial mass. Nasal biopsy indicated the presence of a schwannoma. The lesion was totally removed through a bifrontal craniotomy and the skull base was repaired with periosteal flap, fibrin glue and a split craniotomy graft. In addition to the cosmetic advantages over standard transfacial approaches, the extended subfrontal approach also provides early dissection of neural tissues, avoiding an inadvertent cerebrospinal fluid leak.
Bezircioğlu
Hamdi
H
Ataturk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey. drhamdibezirci@yahoo.com
Sucu
Hasan Kamil
HK
Rezanko
Türkan
T
Minoğlu
Mustafa
M
D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D035262:Cranial Fossa, Anterior / Q000473:pathology*; D005005:Ethmoid Sinus / Q000473:pathology*; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009442:Neurilemmoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D019635:Neurosurgical Procedures; D010256:Paranasal Sinuses / Q000473:pathology*; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D014057:Tomography, X-Ray Computed