title: Vidian nerve neurofibroma removed via a transpterygoid approach.
abstract: BACKGROUND
  Lesions originating in the vidian canal are extremely rare. Most frequently, they are extensions from contiguous carcinomas. We present a rare case of a vidian nerve neurofibroma and discuss its surgical management.
  
  
  METHODS
  A 62-year-old woman with a history of a basal cell skin cancer was evaluated for bilateral tinnitus. Imaging revealed a left-sided lesion at the medial aspect of the pterygoid process base, over the vidian canal. Under image-guidance, an endonasal endoscopic transpterygoid approach was performed. The histopathological examination supported the diagnosis of neurofibroma.
  
  
  CONCLUSIONS
  Benign nerve sheath tumors of the vidian nerve should be considered in the differential diagnosis of a vidian canal lesion. Given the propensity of more aggressive tumors, a tissue diagnosis should be warranted in order to coordinate appropriate subsequent treatment. The expanded endonasal transpterygoid approach offers a safe, less invasive, and effective route to perform the excisional biopsy of such a lesion.
authors.affiliation: Brain Tumor Center, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA.
authors.forename: N
authors.initials: N
authors.lastname: McLaughlin
authors.forename: D
authors.initials: D
authors.lastname: Bresson
authors.forename: L F S
authors.initials: LF
authors.lastname: Ditzel Filho
authors.forename: R L
authors.initials: RL
authors.lastname: Carrau
authors.forename: D F
authors.initials: DF
authors.lastname: Kelly
authors.forename: D M
authors.initials: DM
authors.lastname: Prevedello
authors.forename: A B
authors.initials: AB
authors.lastname: Kassam
mesh_terms: D003390:Cranial Nerve Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009455:Neurofibroma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D056739:Pterygopalatine Fossa; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome