Abstract

Carotid sympathetic plexus (CSP) schwannomas are rare brain tumors located in a complex site around the cavernous sinus (CS) and carotid canal in the petrous bone. This study describes three cases of CSP schwannomas that underwent surgical removal of the tumor through an endoscopic endonasal transpterygoid approach.Between 2016 and 2021, three cases of CSP schwannomas were treated using an endoscopic endonasal transpterygoid approach. Preoperative tumor size, preoperative and postoperative symptoms, internal carotid artery (ICA) displacement, extent of tumor resection, intraoperative findings showing tumor origin, and surgical complications were evaluated in all patients.Two tumors were in the petrous region, and the other one was in both the petrous and cavernous regions. The median tumor diameter was 41.3 mm. In the three cases, the ICA was displaced to the superolateral side, the anterolateral side, and the posterior side, respectively. Near-total resection was achieved in all three cases via an endoscopic endonasal transpterygoid approach. There were no endonasal postoperative complications, and the cranial nerve disability improved in all three patients at one-year follow-up.The surgical technique for CPS schwannoma using an endoscopic endonasal transpterygoid approach may be a viable option because endoscopy has been proven to offer better intraoperative visualization and reduce postoperative discomfort for patients. Tumors located medial and inferior to the ICA pars CS or anterior, inferior, and medial to the paraclival ICA are ideal candidates for surgery using this endoscopic approach.

View details for DOI 10.1016/j.wneu.2022.10.118

View details for PubMedID 36332778