The intranasal endoscopic removal of schwannoma of the pterygopalatine and infratemporal fossae via the prelacrimal recess approach.
OBJECTIVE
This study was undertaken to analyze the results of a novel surgical method-the endoscopic prelacrimal recess approach (PLRA)-in patients with tumors involving the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). The surgical technique and indications for this approach are also discussed.


METHODS
The authors analyzed data from 7 cases involving patients who underwent resection of PPF and ITF tumors by means of the endoscopic PLRA from 2004 to 2013. Preoperative and postoperative imaging studies were available in all cases and were reviewed. The surgical specimens were all confirmed to be schwannomas.


RESULTS
All tumors were completely resected via endoscopic PLRA. There were no recurrences noted over a 28-month follow-up period. In 4 cases, the patients experienced postoperative facial numbness during the first two weeks after surgery, which gradually lessened thereafter. One patient continued to have mild facial numbness at most recent follow-up. The numbness had fully resolved in the other 3 cases.


CONCLUSIONS
The intranasal endoscopic removal of schwannoma from PPF and ITF via PLRA can spare the whole lateral nasal wall, resulting in a reduction in morbidity. This is a novel minimally invasive surgical method for PPF and ITF tumors.
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing;
Bing
B
Zhou
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing;
Qian
Q
Huang
Department of Otolaryngology, Kuang-Tien General Hospital, Department of Biotechnology, Hung-Kuang University, Taichung, Taiwan;
Ping-Hung
PH
Shen
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing;
Shun-Jiu
SJ
Cui
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing;
Cheng-Shuo
CS
Wang
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing;
Yun-Chuan
YC
Li
Department of Otolaryngology, Nanjing Tongren Hospital, Nanjing; and.
Zhen-Kun
ZK
Yu
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing;
Xiao-Hong
XH
Chen
Department of Otolaryngology, Beijing Tiantan Hospital, Beijing, China.
Ting
T
Ye
D000328:Adult; D004724:Endoscopy / Q000379:methods*; D020220:Facial Nerve Injuries / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D009442:Neurilemmoma / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D056739:Pterygopalatine Fossa / Q000601:surgery*; D016896:Treatment Outcome
IMA = internal maxillary artery; ITF = infratemporal fossa; PLRA = prelacrimal recess approach; PPF = pterygopalatine fossa; TEM = transnasal endoscopic maxillectomy; endoscopic sinus surgery; infratemporal fossa; prelacrimal recess; pterygopalatine fossa; schwannoma; surgical technique