Vidian nerve schwannoma with middle cranial fossa extension resected via a maxillary swing approach.

Abstract

Vidian nerve schwannoma is an extremely rare type of facial nerve schwannoma. To the best of our knowledge, only 1 case has been reported. We report an additional case of vidian nerve schwannoma with middle cranial fossa extension in a 49-year-old Japanese woman. The surgical approaches for infratemporal fossa schwannomas are reviewed, and the maxillary swing approach we used is described. We adopted a maxillary swing approach combined with endonasal endoscopic techniques for the resection of the lesion. Gross total resection was achieved without sacrificing the trigeminal nerves or the facial motor nerves. The postoperative course was uneventful. Vidian nerve schwannoma is located in the retro-maxillary space. It can grow silently until it involves the median skull base extensively. The maxillary swing approach was useful in this case.