Endoscopic transnasal resection of the CP angle schwannoma

Satoshi Kiyofuji; Masahiro Shin; Kenji Kondo; Tsukasa Koike; Taichi Kin; Nobuhito Saito

doi:10.3171/2020.4.FocusVid.19891

Endoscopic transnasal resection of the CP angle schwannoma

Neurosurg Focus Video. 2020 Apr 1;2(2):V13. doi: 10.3171/2020.4.FocusVid.19891. eCollection 2020 Apr.

Authors

Satoshi Kiyofuji¹, Masahiro Shin¹, Kenji Kondo¹, Tsukasa Koike¹, Taichi Kin¹, Nobuhito Saito¹

Affiliation

¹ Department of Neurosurgery, University of Tokyo Hospital, Tokyo, Japan.

Abstract

Cerebellopontine (CP) angle tumors are often resected via retrosigmoid craniotomy; however, sometimes cranial nerves (CNs) make their resection more complex. In such cases, the endoscopic transnasal approach can avoid such manipulations as delivering surgical instruments over CNs or peeling off CNs from the tumor, minimizing the risk of postoperative deficits. A 35-year-old man presented with a 37-mm cystic tumor in the right CP angle, and preoperative 3D fusion images revealed that multiple CNs (VII, VIII, and lower CNs) were running on the tumor posteriorly. The endoscopic transnasal approach enabled safe subtotal resection without causing neurological deficits, and the patient underwent stereotactic radiosurgery for the residual schwannoma. The video can be found here: https://youtu.be/xKLwdDsLpWA.

Keywords: endoscopic surgery; lower cranial nerve schwannoma; three-dimensional fusion images; transnasal surgery; transsphenoid surgery; video.