Strategic management of Anterior skullbase schwannomas and their outcomes

Abstract: Objective- Endoscopic endonasal approach has revolutionized the surgery of benign nose and paranasal sinus tumors. In this study we describe our experience with this approach for schwannomas of anterior skullbase which are extremely rare, vascular tumors of this region. We have also discussed the strategic management and their outcomes to enlighten the existing literature. Design- Ambispective study. Setting and participants - A total of 8 cases of anterior skullbase schwannoma were included. These cases were operated between 2018 to 2023 at a tertiary institute. Institutional ethical committee approval was obtained. Main outcomes measured - Medical records were obtained, and peri-operative details (intraoperative findings, imaging findings, Complications) were noted. Post-operative follow- up were done to note the outcomes of the patient. Results- There were 5 males and 3 female patients. All patients were between 20 to 40 years of age. All patients underwent Contrast CT as well as MRI pre-operatively. Most common symptoms in our series were nasal obstruction and intermittent epistaxis. The various sites involved were ethmoid labyrinth, maxillary sinus, septum, olfactory fossa. All the cases were operated endoscopically. Conclusion- Endoscopic approach can be utilized in almost all cases of benign anterior skullbase tumors with superior post-operative outcomes. Although there is a steep learning curve, use of subtle modifications of this technique help achieve better results. At the same time, it is imperative to understand that the surgeon should also be well versed with open approaches to help navigate difficult cases.

Publication History

Received: 08 June 2024

Accepted after revision: 24 November 2024

Accepted Manuscript online:
02 December 2024