The surgical management of nasal skull base schwannoma under endonasal endoscope: a retrospective review of 52 cases
10.3760/cma.j.issn.1673-0860.2018.04.004
- VernacularTitle: 鼻内镜手术治疗鼻颅底神经鞘瘤：52例经验总结
- Author:
Lu YANG
1
;
Weidong ZHAO
2
;
Quan LIU
1
;
Huankang ZHANG
1
;
Dehui WANG
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China
2. Department of Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China
- Publication Type:Journal Article
- Keywords:
Endoscopes;
Neurilemmoma;
Skull base
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2018;53(4):257-262
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the surgical technique and outcome of nasal skull base schwannoma treated under endonasal endoscope.
Methods:Fifty-two patients with nasal skull base nonvestibular schwannoma were treated under endonasal endoscope from May 2006 to June 2017 in Shanghai E&ENT Hospital. Of the patients, there were 21 men and 31 women. The age of the patients ranged from 33 to 71 years.Schwannoma mainly came from trigeminal nerve.Clinical symptoms included facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus. Surgical approaches included pure endonasal endoscope approach (18 cases) and endoscopic endonasal resection asissted with sublabial transmaxillary approach (34 cases).
Results:Total tumor resection was achieved in 42 patients(80.8%), subtotal resection in 8 patients, and partial resection in 2 patients. The relief rate of facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus were 68.8%, 45.5%, 100.0%, 90.0%, 60.0%, 40.0% and 100.0%, respectively. During surgery, cerebrospinal fluid leakage was observed in 5 cases. All cases were successfully repaired with a nasoseptal flap or autologous fascia lata and fat obtained from thigh. Four cases with recurrence were observed in the follow-up period (6-134 months).
Conclusion:Endonasal endoscopic approach is a safe and feasible procedure for schwannoma in nasal cavity, paranasal sinus, orbital apex, pterygopalatine fossa, infratomporal fossa, cavernous sinus and Meckel cave.
