title: Endoscopic endonasal approach for the treatment of schwannomas of the pterygopalatine fossa: case report and review of the literature.
abstract: BACKGROUND
  Pterygopalatine fossa (PPF) schwannomas are rare lesions most often arising from branches of the trigeminal nerve. Symptomatic lesions have been traditionally treated by conventional external approaches. However, the development of an expanded endonasal approach (EEA) enables skull base surgeons to reach these deeply seated lesions via a different route with its own advantages and drawbacks.
  
  
  METHODS
  Case report and review of the literature.
  
  
  METHODS
  A 41-year-old woman presented with a 6-year history of right facial pain and numbness. Her symptoms had increased progressively over a year, and she recently had developed right-sided otalgia. MRI revealed a right PPF mass, hypointense on T1 and T2 sequences with homogeneous enhancement following the use of gadolinium. A biopsy, attempted at another institution, was considered non-diagnostic. We totally removed the lesion through an endoscopic endonasal transmaxillary approach. Final pathology confirmed the diagnosis of schwannoma. Post-operatively, the patient noted a significant improvement of her facial pain (V2 territory).
  
  
  CONCLUSIONS
  The endonasal endoscopic transmaxillary approach provides adequate access to the PPF, thus enabling safe tumor removal with less morbidity than conventional routes.
authors: Department of Neurosurgery, hôpital Lariboisière, Paris, France.
authors: D
authors: D
authors: Bresson
authors: John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, United States.
authors: N
authors: N
authors: McLaughlin
authors: Department of Neurosurgery, Ohio State University, Columbus, OH, United States.
authors: L F S
authors: LF
authors: Ditzel Filho
authors: John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, United States.
authors: C F
authors: CF
authors: Griffiths
authors: Department of Otolaryngology-Head & Neck Surgery, Ohio State University Medical Center, 456, West 10th Avenue Cramblett-Hall, Suite 4A, 43210-1282 Columbus, OH, United States. Electronic address: ricardo.carrau@osumc.edu.
authors: R L
authors: RL
authors: Carrau
authors: John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, United States.
authors: D F
authors: DF
authors: Kelly
authors: Department of Neurosurgery, University of Ottawa, Ottawa, ON, Canada.
authors: A B
authors: AB
authors: Kassam
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D009296:Nasal Cavity / Q000473:pathology / Q000601:surgery*; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D056739:Pterygopalatine Fossa / Q000473:pathology / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000473:pathology / Q000601:surgery
keywords: Chirurgie endoscopique endonasale; Endonasal endoscopic surgery; Fosse ptérygopalatine; Nerf trijumeau; Pterygopalatine fossa; Schwannoma; Schwannome; Trijeminal nerve