Endonasal endoscopic removal of a large intracranial infratemporal fossa trigeminal schwannoma: A case report and literature review

Introduction: Trigeminal schwannoma is a rare, benign, solitary tumor arising from the trigeminal nerve. Patients commonly present with symptoms such as facial pain and paraesthesia. Multiple approaches have been introduced to access the intracranial and infratemporal fossae. Case presentation: A 39-year-old female patient complains of a mild headache on the right side, with right vision and hearing loss, right facial weakness, and dysphagia. The CT and MRI indicated a large dumbbell-shaped mass extending across the right side of the skull base, from the middle cranial fossa to the infratemporal fossa. An endoscopic endonasal approach allows a more detailed view of the midline structures by drilling the pterygoid bone and dissecting the pterygoid muscle. Conclusion: The endonasal endoscopic approach is an excellent method for patients with trigeminal schwannoma in intracranial and infratemporal fossae. Familiarity with the microsurgical anatomy of the infratemporal fossa dissection techniques via anterior and lateral approaches helps provide the best results and achieve the goal of tumor removal with minimal morbidities.