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

Hideaki Ono; Seiei Torazawa; Takeo Tanishima; Akira Tamura; Isamu Saito

doi:10.1055/s-0041-1736630

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

J Neurol Surg B Skull Base. 2021 Nov 23;83(Suppl 3):e659-e660. doi: 10.1055/s-0041-1736630. eCollection 2022 Aug.

Authors

Hideaki Ono¹, Seiei Torazawa^{1

2}, Takeo Tanishima¹, Akira Tamura¹, Isamu Saito¹

Affiliations

¹ Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan.
² Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.

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.

Keywords: cavernous sinus; extradural approach; middle fossa approach; transcavernous approach; trigeminal neurinoma.

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