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Minim Invasive Neurosurg 2011; 54(05/06): 250-252
DOI: 10.1055/s-0031-1283126
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Vidian Nerve Neurofibroma Removed via a Transpterygoid Approach

N. McLaughlin
1   Brain Tumor Center, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA
,
D. Bresson
1   Brain Tumor Center, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA
,
L.F. S. Ditzel Filho
1   Brain Tumor Center, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA
,
R. L. Carrau
1   Brain Tumor Center, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA
,
D. F. Kelly
1   Brain Tumor Center, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA
,
D. M. Prevedello
2   Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA
,
A. B. Kassam
3   Department of Surgery, Division of Neurosurgery, University of Ontario, Ontario, Canada
› Author Affiliations
Further Information

Publication History

Publication Date:
25 January 2012 (online)

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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.

Case Report:

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.

Conclusion:

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.

Key words

vidian nerve - vidian canal - neurofibroma - endoscopy - expanded endonasal approach - transpterygoid approach
 

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