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CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2022; 83(S 03): e659-e660
DOI: 10.1055/s-0041-1736630
Skull Base: Operative Videos

Extradural Middle Fossa and Transcavernous Approach for Resection of Trigeminal Neurinoma at Lateral Cavernous Sinus

Hideaki Ono 
1   Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan
,
Seiei Torazawa
1   Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan
2   Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
,
Takeo Tanishima
1   Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan
,
Akira Tamura
1   Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan
,
Isamu Saito
1   Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan
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Abstract

We present a 52-year-old male case of right trigeminal neurinoma at lateral cavernous sinus. The tumor was 40 mm in maximum diameter, obviously compressed temporal lobe and encased internal carotid artery. Extradural middle fossa and transcavernous approach was applied and the tumor was resected via Parkinson's triangle. This approach enabled safe and effective tumor resection, sufficient visualization, and operative field ([Figs. 1] and [2]). We performed dissection of the tumor from trigeminal nerve, tentorium, and middle fossa and resect the tumor around internal carotid artery sufficiently. Postoperative course was good without any new neurological deficit. This surgical method is considered safe and effective for the resection of the tumor at lateral cavernous sinus.

The link to the video can be found at: https://youtu.be/2ekuILIgEuo.


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Keywords

trigeminal neurinoma - cavernous sinus - extradural approach - middle fossa approach - transcavernous approach
Zoom Image
Fig. 1 Pre- and postoperative magnetic resonance imaging.
Zoom Image
Fig. 2 Intraoperative images and schema. (A) The tumor capsule is incised, (B) detachment from trigeminal nerve, and (C) tumor surrounding internal carotid artery is resected (*tumor; arrowhead: trigeminal nerve; arrow: internal carotid artery). (D) Schema of the final operative field (V1: ophthalmic nerve, V2: maxillary nerve, V3: mandibular nerve).

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Qualität:

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Conflict of Interest

None declared.

Address for correspondence

Hideaki Ono, MD, PhD
Department of Neurosurgery, Fuji Brain Institute and Hospital
270-12, Sugita, Fujinomiya-City, Shizuoka, 418-0021
Japan   

Publikationsverlauf

Eingereicht: 01. April 2020

Angenommen: 23. September 2021

Artikel online veröffentlicht:
23. November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Zoom Image
Fig. 1 Pre- and postoperative magnetic resonance imaging.
Zoom Image
Fig. 2 Intraoperative images and schema. (A) The tumor capsule is incised, (B) detachment from trigeminal nerve, and (C) tumor surrounding internal carotid artery is resected (*tumor; arrowhead: trigeminal nerve; arrow: internal carotid artery). (D) Schema of the final operative field (V1: ophthalmic nerve, V2: maxillary nerve, V3: mandibular nerve).