• Donny Wisnu Wardhana, Hiroki Morisako, Tsuyoshi Sasaki, Masaki Ikegami, Yuichi Teranishi, Juan Carlos Fernandez-Miranda, and Takeo Goto.
• Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
• World Neurosurg. 2023 Jan 1; 169: e221e229e221-e229.

ObjectiveCarotid sympathetic plexus (CSP) schwannomas are rare brain tumors located in a complex site around the cavernous sinus and carotid canal in the petrous bone. This study describes 3 cases of CSP schwannomas that underwent surgical removal of the tumor through an endoscopic endonasal transpterygoid approach.MethodsBetween 2016 and 2021, 3 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.ResultsTwo 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 3 cases, the ICA was displaced to the superolateral side, the anterolateral side, and the posterior side, respectively. Near-total resection was achieved in all 3 cases via an endoscopic endonasal transpterygoid approach. There were no endonasal postoperative complications, and the cranial nerve disability improved in all 3 patients at 1-year follow-up.ConclusionsThe 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 cavernous sinus or anterior, inferior, and medial to the paraclival ICA are ideal candidates for surgery using this endoscopic approach.Copyright © 2022 Elsevier Inc. All rights reserved.

10 keywords...

hide…