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. McLaughlin1, D. Bresson1, L.F. S. Ditzel Filho1, R. L. Carrau1, D. F. Kelly1, D. M. Prevedello2, A. B. Kassam3
  • 1Brain Tumor Center, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA
  • 2Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA
  • 3Department of Surgery, Division of Neurosurgery, University of Ontario, Ontario, Canada
Further Information

Publication History

Publication Date:
25 January 2012 (online)

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.