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학술저널

내시경적 경비강 접근법을 통한 재발성 삼차신경초종의 제거

An Endoscopic Endonasal approach for Recurred Trigeminal Schwannoma

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Introduction : We report a case of repeatedly recurred trigeminal schwannoma after transcranial resection, operated via endoscopic endonasal approach. Case presentation : A 47-years-old female presented with intermittent headache, tinnitus, and hearing loss of right side. The magnetic resonance images showed the right cerebellopontine angle (CPA) mass consist of well enhancing solid and multiple cystic portions. The lesion was removed several times via transcranial approach. However, the residual lesion was consistently enlarged over the years and extended to prepontomedullary cistern, Meckel’s cave, and suprasellar area combined with related progression of symptoms. The recurred mass was removed via endoscopic endonasal combined transtubercular and trans-clival approach. We performed nearly total resection. There was no postoperative neurologic deficit and morbidity including the leakage of cerebrospinal fluid. Conclusion : The endoscopic endonasal combined trans-tubercular and trans-clival approach could be a safe and an alternative surgical option for the recurred trigeminal schwannoma extending to suprasellar area after repeatedly transcranial resection.

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